直肠肛管周围脓肿行Ⅰ期切开引流挂线术的效果分析  

The Effect of One-stage Incision,Drainage,and Thread-Drawing Surgery on Perianal Abscess of the Rectum

作　　者：朱洪海 徐景龙 ZHU Honghai;XU Jinglong(Anorectal Surgery,Guangze County Hospital of Traditional Chinese Medicine,Guangze 354100,Fujian Province,China)

机构地区：[1]福建省南平市光泽县中医院肛肠外科,福建南平354100

出　　处：《中国实用乡村医生杂志》2023年第7期36-39,43,共5页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨对直肠肛管周围脓肿患者行Ⅰ期切开引流挂线术的治疗效果。方法选取2020年1月—2022年10月光泽县中医院收治的80例直肠肛管周围脓肿患者,所有患者依据随机数字表法分为单一引流组和切开引流挂线术组各40例,单一引流组行切开引流术治疗,切开引流挂线术组行切开引流挂线术治疗。观察比较两组的住院时间､肛门切口愈合时间,术后创面水肿和疼痛程度;术后1个月患者直肠最大耐受阈值､肛管最大收缩压､肛管静息压及生活质量;两组术后3个月内肛瘘及脓肿复发情况。结果切开引流挂线术组住院时间､肛门切口愈合时间较单一引流组短,术后7 d创面水肿和疼痛评分较单一引流组低,术后1个月直肠最大耐受阈值､肛管最大收缩压､肛管静息压较单一引流组大,生活质量评分较单一引流组高,术后3个月内肛瘘形成率､脓肿复发率较单一引流组低,差异均有统计学意义(均P<0.05)。结论给予直肠肛管周围脓肿患者Ⅰ期切开引流挂线术治疗,可缩短住院时间及肛门切口愈合时间,减轻肛门疼痛及水肿程度,促进肛门功能恢复,提高患者生活质量,降低肛瘘形成率及脓肿复发率,值得推广使用。Objective To explore the therapeutic effect of primary incision,drainage and thread-drawing surgery on patients with perianal abscess.Methods A total of 80 patients with perianal abscess admitted to Guangze County Hospital of Traditional Chinese Medicine from January 2020 to October 2022 were selected.All patients were randomly divided into single drainage group and incision,drainage and thread-drawing group with 40 cases each.The single drainage group was treated with incision drainage,and the incision drainage and thread-drawing group was treated with incision drainage and thread-drawing.The hospital stay,anal incision healing time,postoperative wound edema and pain of the two groups were observed and compared.The patient’s maximum rectal tolerance threshold,maximum anal systolic pressure,anal resting pressure,and quality of life at one month after surgery,and the recurrence of anal fistula and abscess within 3 months after surgery were observed in both groups.Results The hospitalization time and anal incision healing time of the incision drainage and thread-drawing surgery group were significantly shorter than those of the single drainage group,and the wound edema and pain scores were significantly lower than those of the single drainage group at 7 days after surgery.The maximum tolerance threshold of the rectum,maximum contraction pressure of the anal canal,and resting pressure of the anal canal in incision,drainage and thread-drawing group were significantly higher than those of the single drainage group at 1 month after surgery,andthe quality of life score was significantly higher than that of the single drainage group.The rate of anal fistula formation and abscess recurrence within 3 months after surgery was significantly lower than that of the single drainage group(all P<0.05).Conclusion Providing one-stage incision drainage and thread-drawing surgery for patients with perianal abscess can shorten hospitalization time and anal incision healing time,reduce anal pain and edema,promote anal function recove

关 键 词：直肠肛管周围脓肿 切开引流挂线术 Ⅰ期 效果 肛门功能 复发 

分 类 号：R657.15[医药卫生—外科学]