肛瘘瘘管剔除与对口引流保留皮桥术联合应用治疗单纯性肛瘘的临床效果观察  

Clinical observation on the treatment of simple anal fistula by combination of removal of anal fistula and contra-oral drainage and skin bridging

作　　者：张英 周西华 袁东辉 ZHANG Ying;ZHOU Xi-hua;YUAN Dong-hui(Department of Anorectal Surgery,Yongcheng General Hospital,Yongcheng,Henan 476600,China)

机构地区：[1]永煤集团总医院肛肠科,河南永城476600

出　　处：《医药论坛杂志》2023年第2期67-70,共4页Journal of Medical Forum

摘　　要：目的 观察单纯性肛瘘患者外科手术治疗中,使用瘘管剔除术式与结合对口引流保留皮桥术式的临床有效性。方法 纳入永煤集团总医院肛肠科临床收入治疗的68例肛瘘患者作为研究对象进行研究,患者均为单纯性的肛瘘,纳入时间范围是2020年2月1日—2021年2月1日,将其中单纯给予瘘管剔除术式的34例设为A组,另外结合对口引流保留皮桥术式的34例设为B组,观察并比较两组患者的手术效果。结果 (1)A组与B组患者术后1 d时的QOL评分与VAS评分无明显差异性,P>0.05;但是B组术后7 d时的QOL评分较A组高、VAS评分较A组低,组间比较有差异,P<0.05。(2)B组患者术后的Wexner评分较A组低,创面愈合时长与术后住院时长均较A组短,组间比较差异有统计学意义,P<0.05。(3)A组患者本次手术治疗的总有效率是79.41%,术后并发症的总发生率是17.71%;B组患者本次手术治疗的总有效率是94.12%,术后并发症的总发生率是11.76%,两组患者的并发症对比无差异,P>0.05,但B组的治疗效果较A组高,组间比较有差异,P<0.05。结论 对单纯性肛瘘患者而言,临床治疗中采取单纯瘘管剔除的同时,结合口引流保留皮桥手术,可以提高手术效果,且术后疼痛程度低、并发症少、康复时间短、肛门功能恢复快,具有较高的临床价值,建议广泛运用。Objective To observe the clinical effectiveness of fistula removal and skin bridge retention combined with opposite drainage in the surgical treatment of patients with simple anal fistula. Methods Totally 68 cases of simple anal fistula patients who admited to Yongcheng General Hospital anorectal department from February 1,2020-February 1, 2021 as the research object and divided the 34 cases of pure fistula eliminate operation as group A, the 34 case of skin bridge operation combined with opposive drainage as group B, The surgical effect of the two groups was observed and compared. Results(1)There was no significant difference between QOL score and VAS score on postoperative day 1 between group A and group B(P>0.05). However, the QOL score and VAS score of group B at postoperative 7d respectivery were higher and lower than those of group A, and there were differences between the two groups(P<0.05).(2)The postoperative Wexner score of patients in group B was lower than that in group A, and the duration of wound healing and postoperative hospitalization were shorter than that in group A, with differences between groups(P<0.05).(3)In group A, the total effective rate was 79.41%, and the total incidence of postoperative complications was 17.71%. In group B, the total effective rate of this operation was 94.12%, and the total incidence of postoperative complications was 11.76%. There was no difference in the complications between the two groups(P>0.05), but the treatment effect of group B was higher than that of group A, and there was difference between the two groups(P<0.05). Conclusion For patients with simple anal fistula, simple fistula removal combined with oral drainage and skin bridge preservation surgery in clinical treatment can improve the surgical effect, and reduce the postoperative pain degree and less complications, shorten recovery time, quicken the recovery of anal function, has a high clinical value, it is recommended to be widely used.

关 键 词：肛瘘 瘘管剔除 对口引流保留皮桥手术 疼痛评分 生活质量 Wexner评分 

分 类 号：R657.1[医药卫生—外科学]