肛瘘切开术与切除术在低位单纯性肛瘘治疗中的临床效果比较  

Comparison on the clinical effect of anal fistulotomy and fistulectomy in the treatment of low simple anal fistula

作　　者：司海波 SI Hai-bo(Department of Colorectal and Anal Surgery,Chaoyang Central Hospital,Chaoyang 122000,China)

机构地区：[1]朝阳市中心医院结直肠肛门外科,122000

出　　处：《中国实用医药》2023年第5期61-63,共3页China Practical Medicine

摘　　要：目的比较肛瘘切开术与切除术在低位单纯性肛瘘治疗中的临床效果。方法128例低位单纯性肛瘘患者,按照随机分配原则分为切开组和切除组,每组64例。切除组患者进行肛瘘切除术治疗,切开组患者进行肛瘘切开术治疗。比较两组患者各临床指标[手术时间、术中出血量、创口愈合时间、术后视觉模拟评分法(VAS)评分]、并发症发生情况及复发情况。结果切开组患者的手术时间为(14.17±1.76)min,短于切除组的(17.43±1.81)min,差异具有统计学意义(P<0.05);切开组患者的创口愈合时间为(20.72±3.15)d,明显短于切除组的(26.48±3.27)d,差异有统计学意义(P<0.05)。两组术中出血量、术后VAS评分比较差异无统计学意义(P>0.05)。两组患者术后并发症发生率比较差异无统计学意义(P>0.05);术后3个月随访,切开组患者复发率18.75%明显高于切除组的4.69%,差异有统计学意义(P<0.05)。结论在低位单纯性肛瘘治疗中肛瘘切除术与肛瘘切开术的治疗效果均较好,且操作简易,创口小,并发症发生率较低;肛瘘切开术较切除术所用手术时间更短、创口愈合时间较快,但其后续的复发率高于切除术,两者皆具有临床应用价值。Objective To compare the clinical effect of anal fistulotomy and fistulectomy in the treatment of low simple anal fistula.Methods A total of 128 patients with low simple anal fistula were randomly divided into incision group and resection group,with 64 cases in each group.The incision group was treated with anal fistulotomy,and the resection group was treated with anal fistulectomy.The clinical indicators[operation time,intraoperative blood loss,wound healing time,postoperative visual analogue scale(VAS)],incidence of complications and recurrence rate were compared between the two groups.Results The operative time was(14.17±1.76)min in the incision group,which was shorter than(17.43±1.81)min in the resection group,and the difference was statistically significant(P<0.05).The wound healing time was(20.72±3.15)d in the incision group,which was significantly shorter than(26.48±3.27)d in the resection group,and the difference was statistically significant(P<0.05).The differences in intraoperative blood loss and postoperative VAS scores between the two groups were not statistically significant(P>0.05).There was no statistically significant difference in the incidence of postoperative complications comparing the two groups(P>0.05).At the 3-month postoperative follow-up,the recurrence rate in of 18.75%the incision group was significantly higher than that of 4.69%in the resection group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of low simple anal fistula,both anal fistulotomy and fistulectomy have better therapeutic effects,and are easy to perform,with small incisions and lower complication rates;anal fistulotomy has shorter operative time and wound healing time than anal fistulectomy,but its subsequent recurrence rate is higher than that of anal fistula resection,both of which have clinical application value.

关 键 词：低位单纯性肛瘘 肛瘘切开术 肛瘘切除术 临床效果 

分 类 号：R657.16[医药卫生—外科学]