减创肛瘘根治术治疗婴幼儿低位肛瘘的安全性与有效性的临床研究  

Clinical research on the safety and effectiveness of low-trauma radical resection in the treatment of low anal fistula in infants and children under 3 years old

作　　者：李佳楠[1] 王晏美[1] 马凰富 来丽霞[1] 杨涵雯 王月 郁强 LI Jia-nan;WANG Yan-mei;MA Huang-fu(Department of Anorectal Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院肛肠科,北京100029

出　　处：《中日友好医院学报》2023年第3期136-139,154,F0003,共6页Journal of China-Japan Friendship Hospital

基　　金：国家自然科学基金(81473689);国家中医药管理局中医药重点学科建设项目(2012年);北京市自然科学基金(7202112);中日友好医院院级科研基金(2018-2-QN-27,2019-1-QN-39)。

摘　　要：目的:观察减创肛瘘根治术治疗婴幼儿低位肛瘘的安全性及临床疗效。方法:将100例小儿低位肛瘘患者,分为治疗组和对照组,每组50例。治疗组行减创肛瘘根治术,对照组采用莫匹罗星软膏外涂治疗。均随访6个月以上,观察比较治疗后2组患儿的肛门疼痛情况、创面愈合时间、Wexner肛门功能评分及临床疗效。结果:2组患儿治疗后第1d疼痛程度差异无统计学意义(P>0.05),治疗组在治疗后第2d、3d疼痛评分高于对照组,第7d、14d、21d疼痛评分低于对照,差异均有统计学意义(P<0.01)。治疗组创面愈合时间低于对照组,临床疗效显著优于对照组,差异均有统计学意义(P<0.01)。治疗后3周、6个月时肛门失禁Wexner评分治疗组均优于对照组,差异均有统计学意义(P<0.01)。结论:减创肛瘘根治术治疗婴幼儿低位肛瘘安全性好、疗效显著,同时可较好保护患儿肛门功能。Objective:To observe the safety and clinical efficacy of"reduced wound anal fistula radical resection"in the treatment of infant low anal fistula.Methods:A total of 100 cases aged 3 months to 3 years with low anal fistula were divided into treatment group and control group,with 50 in each group.The treat-ment group was treated with"reduced wound anal fistula radical resection",and the control group was treated with mupiroxin ointment.Both groups were followed up for 6 months.Anal pain,wound healing time,Wexner anal function score and clinical efficacy were observed after the treatment.Results:There was no significant difference in pain degree between the two groups on the first day after treatment(P>0.05).The pain score of the treatment group on the second and third days after treatment was higher than that of the control group(P<0.01),and the pain score on the seventh,14th and 21st days was lower than that of the control group(P<0.01).The wound healing time of the treatment group was lower than that of the control group(P<0.01).The clinical effect of treatment group was significantly better than that of the control group(P<0.01).Wexner score of anal incontinence in the treatment group was better than that in the control group at 3 weeks and 6 months after treatment(P<0.01).Conclusion:"Reduced wound anal fistula radical resection"has a significant effect on the treatment of low anal fistula in infants,and can better protect the anal function of infant patients.

关 键 词：婴幼儿 低位肛瘘 手术治疗 减创肛瘘根治术 

分 类 号：R726.1[医药卫生—儿科] R266[医药卫生—临床医学]