双间隙挂线引流联合自拟清热消肿止痛方熏洗坐浴治疗肛周脓肿的效果评价  

Effect Evaluation of Double-gap Thread Hanging Drainage Combined with Self-made Qingre Xiaozhong Zhitong Formula Fumigation and Sitz Bath in the Treatment of Perianal Abscess

作　　者：史瑞霞 朱念华 华浩 耿俊 SHI Ruixia;ZHU Nianhua;HUA Hao;GENG Jun(Wuxi Xishan People's Hospital,Jiangsu Province,Wuxi 214000,China;不详)

机构地区：[1]江苏省无锡市锡山人民医院,江苏无锡214000

出　　处：《中国医学创新》2023年第5期70-73,共4页Medical Innovation of China

基　　金：无锡市中医药管理局科技项目(ZYKJ202019)。

摘　　要：目的:评价双间隙挂线引流联合自拟清热消肿止痛方熏洗坐浴治疗肛周脓肿的效果。方法:将2020年1月-2021年6月在无锡市锡山人民医院治疗的64例肛周脓肿患者随机分为标准组和挂线组,各32例,分别择期行标准切开引流、双间隙挂线引流,术后均予以自拟清热消肿止痛方熏洗坐浴。对两组的临床疗效、感染控制时间、创面愈合时间、视觉模拟评分法(VAS)评分、围手术期并发症、术后成瘘率和肛瘘类型进行对比。结果:挂线组临床总有效率高于标准组(P<0.05)。与标准组比较,挂线组感染控制时间和创面愈合时间均明显更短(P<0.05)。术后1 d,两组VAS评分比较,差异无统计学意义(P>0.05);术后3、7、14 d,两组VAS评分均较术后1 d明显降低,且挂线组评分均低于同期标准组(P<0.05)。挂线组围手术期并发症发生率低于标准组(P<0.05)。两组术后成瘘率比较,差异无统计学意义(P>0.05);挂线组主要为括约肌间肛瘘(43.75%),标准组主要为经括约肌肛瘘(81.25%),两组括约肌间肛瘘、经括约肌肛瘘发生率比较,差异均有统计学意义(χ^(2)=9.062、14.414,P<0.05)。结论:双间隙挂线引流联合自拟清热消肿止痛方熏洗坐浴,能够减轻术后疼痛,促进创面愈合,降低复杂型肛瘘的形成。Objective:To evaluate the effect of double-gap thread hanging drainage combined with selfmade Qingre Xiaozhong Zhitong Formula fumigation and sitz bath in the treatment of perianal abscess.Method:A total of 64 patients with perianal abscess treated in Wuxi Xishan People’s Hospital from January 2020 to June 2021 were randomly divided into standard group and thread hanging group,with 32 cases in each group,and was respectively treated with standard incision and drainage,double-gap thread hanging drainage.All patients were given selfmade Qingre Xiaozhong Zhitong Formula fumigation and sitz bath after operation.The clinical efficacy,infection control time,wound healing time,visual analog scale(VAS)score,perioperative complications,fistula rate and anal fistula type of the two groups were compared.Result:The total clinical effective rate of the thread hanging group was higher than that of the standard group(P<0.05).Compared with the standard group,the infection control time and wound healing time in the thread hanging group were significantly shorter(P<0.05).1 day after operation,there was no significant difference in VAS scores between the two groups(P<0.05).3,7 and 14 days after operation,the VAS scores of the two groups were significantly lower than that of the 1 day after operation,and the scores of the thread hanging group were lower than those of the standard group(P<0.05).The incidence of perioperative complications in the thread hanging group was lower than that in the standard group(P<0.05).There was no significant difference in postoperative fistula rate between the two groups(P>0.05).The main type of anal fistula in the thread hanging group was inter sphincter anal fistula(43.75%),and that in the standard group was trans sphincter anal fistula(81.25%),the incidence rates of intersphincter anal fistula and transsphincter anal fistula were statistically significant between the two groups(χ^(2)=9.062,14.414,P<0.05).Conclusion:Double-gap thread hanging drainage combined with selfmade Qingre Xiaozhong Zhitong

关 键 词：肛周脓肿 双间隙挂线引流 清热消肿止痛方 括约肌间肛瘘 经括约肌肛瘘 

分 类 号：R657.15[医药卫生—外科学]