封闭式中心负压吸引联合垫棉压迫法应用于高位单纯性肛瘘术后的疗效观察  

Therapeutic effect of closed central negative pressure suction combined with cotton pad compression method after surgery for high simple anal fistula

作　　者：朱宝国 金美 姚向阳 张华 张丹凤 彭军良 ZHU Baoguo;JIN Mei;YAO Xiangyang;ZHANG Hua;ZHANG Danfeng;PENG Junliang(Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201501,China)

机构地区：[1]上海市金山区中西医结合医院,上海201501

出　　处：《现代中西医结合杂志》2023年第18期2492-2496,2503,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市金山区卫生健康委员会科研课题(JSKJ-KTZY-2020-03);上海市“十四五”中医特色专科(ZYTSZK1-1);上海市金山区第七周期医学重点专科“攀登计划”建设项目(JSZK2023B05)。

摘　　要：目的观察高位单纯性肛瘘术后采用封闭式中心负压吸引联合垫棉压迫法治疗的效果。方法将2021年1月—2022年12月在上海市金山区中西医结合医院肛肠科行高位单纯性肛瘘瘘管剔除术加内口缝合术的60例患者随机分成治疗组与对照组各30例,对照组术后采用曼纱灵油纱布换药,治疗组术后给予封闭式中心负压吸引联合垫棉压迫法干预,比较2组患者术后肛门疼痛程度、创面分泌物情况、创面肉芽新鲜度、创面愈合率、创面愈合时间以及近远期疗效。结果术后第1,3,7天,治疗组患者的肛门疼痛程度均明显轻于对照组(P均<0.05);术后第7,10天,治疗组患者创面分泌物均明显少于对照组(P均<0.05);术后第7,10,14天,治疗组患者创面肉芽新鲜度均明显优于对照组(P均<0.05);术后第10,14天,治疗组患者的创面愈合率均明显高于对照组(P均<0.05);治疗组患者的创面愈合时间为(22.2±1.5)d,明显短于对照组的(26.6±1.9)d(P<0.05);2组近期疗效比较差异无统计学意义(P>0.05);术后3~6个月随访,2组肛门功能、复发率比较差异均无统计学意义(P均>0.05)。结论高位单纯性肛瘘术后采用封闭式中心负压吸引联合垫棉压迫法处理,可明显减轻术后肛门疼痛,减少创面分泌物,促进创面肉芽组织生长,加快创面愈合,且不会引起明显的肛门功能损伤和复发率增高。Objective It is to observe the effect of closed central negative pressure suction combined with cotton pad compression method after surgery for high simple anal fistula.Methods Sixty patients who underwent fistula excision with internal suture of high simple anal fistula in the Department of Anorectology,Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to December 2022 were randomly divided into treatment group and control group,with 30 cases in each group.In the control group,postoperative dressing change was performed with Manzalin oil gauze,and in the treatment group,postoperative intervention was performed with closed center negative pressure suction combined with cotton pad compression.The degree of anal pain,traumatic secretion,traumatic granulation freshness after surgery,and traumatic healing rate,traumatic healing time,and short-term and long-term efficacy of patients in the two groups were compared.Results On postoperative days 1,3,and 7,the anal pain of patients in the treatment group was significantly milder than that of the control group(all P<0.05);on postoperative days 7 and 10,the traumatic secretion of patients in the treatment group was significantly less than that of the control group(all P<0.05);on postoperative days 7,10,and 14,the traumatic granulomatous freshness of patients in the treatment group was significantly better than that of the control group(all P<0.05);on postoperative days 10 and 14,the wound healing rate of patients in the treatment group was significantly higher than that of the control group(both P<0.05);the wound healing time of patients in the treatment group was(22.2±1.5)d,which was significantly shorter than(26.6±1.9)d of the control group(P<0.05);the difference in the short-term efficacy between the two groups was not statistically significant(P>0.05);after 3 to 6 months of postoperative follow-up,there was no statistically significant difference in anal function and recurrence rate between the two groups(both P>0.05).

关 键 词：封闭式中心负压吸引 垫棉压迫 高位单纯性肛瘘 曼纱灵油纱布 

分 类 号：R657.16[医药卫生—外科学]