比较切开挂线对口引流术与切开挂线旷置引流术治疗肛周脓肿的疗效观察  

Comparison of the clinical curative effects between wire-to-port drainage and put-aside drainage after incision and hanging on perianal abscess

作　　者：贺磊 邵帅 江波[1] He Lei;Shao Shuai;Jiang Bo(Anorectal Department,Anqing Municipal Hospital(Integrated Chinese and Western Medicine),Anqing 246003,China)

机构地区：[1]安庆市立医院肛肠科(中西医结合),安庆246003

出　　处：《中国医师进修杂志》2024年第1期53-57,共5页Chinese Journal of Postgraduates of Medicine

基　　金：安庆市立医院2021年度院级科研项目(2021aqykj04)。

摘　　要：目的分析切开挂线对口引流术与切开挂线旷置引流术治疗肛周脓肿的临床疗效。方法采用前瞻性研究的方法,选取2019年11月至2022年11月安庆市立医院收治的肛周脓肿患者82例,按照随机数字表法分为A组和B组各41例。A组实施切开挂线对口引流术治疗,B组实施切开挂线旷置引流术治疗。比较A组和B组肛周脓肿患者临床疗效、手术时间、创面愈合时间、术后恢复时间和住院时间。采用视觉模拟评分(VAS)和大便失禁严重程度评分(Wexner评分)分别评估患者术前、术后1 d和术后7 d疼痛感和肛门功能。统计患者术后1个月内并发症发生情况。结果两组患者临床总有效率、手术时间比较差异无统计学意义(P>0.05)。A组患者创面愈合时间、术后恢复时间和住院时间均明显短于B组[(21.34±2.21)d比(27.86±2.84)d、(23.12±2.42)d比(28.36±2.91)d、(8.12±0.83)d比(13.25±1.47)d],差异有统计学意义(P<0.05)。术后1和7 d,A组VAS和Wexner评分低于B组[(6.11±0.62)分比(6.54±0.67)分、(2.39±0.25)分比(3.21±0.33)分、(7.54±0.77)分比(8.96±0.91)分、(4.22±0.43)分比(5.68±0.58)分],差异有统计学意义(P<0.05)。两组患者术后1个月总并发症发生率比较差异无统计学意义(P>0.05)。讨论与切开挂线旷置引流术相比,切开挂线对口引流术治疗肛周脓肿患者可促进创面愈合,缩短住院时间,降低术后疼痛感,改善术后肛门功能,具有一定安全性。Objective To analyze the clinical curative effects of wire-to-port drainage and put-aside drainage after incision and hanging on perianal abscess.Methods Eighty-two patients with perianal abscess admitted to Anqing Municipal Hospital between November 2019 and November 2022 were enrolled.The patients were divided into group A(41 cases,incision and hanging wire-to-port drainage)and group B(41 cases,incision and hanging put-aside drainage)by random digits table method.The clinical curative effect,operation time,wound healing time,postoperative recovery time and hospitalization time in the two groups were compared.The pain and anal function were evaluated by visual analogue score(VAS)and Wexner continence grading score(Wexner score)before surgery and 1,7 d after surgery.The occurrence of complications within 1 month after surgery was statistically analyzed.Results There was no significant difference in total clinical response rate between group A and group B(P>0.05).There was no significant difference in operation time between the two groups(P>0.05).The wound healing time,postoperative recovery time and hospitalization time in group A were significantly shorter than those in group B:(21.34±2.21)d vs.(27.86±2.84)d,(23.12±2.42)d vs.(28.36±2.91)d,(8.12±0.83)d vs.(13.25±1.47),P<0.05.At 1 and 7 d after surgery,the VAS and Wexner score in group A were lower than those in group B:(6.11±0.62)points vs.(6.54±0.67)points,(2.39±0.25)points vs.(3.21±0.33)points,(7.54±0.77)points vs.(8.96±0.91)points,(4.22±0.43)points vs.(5.68±0.58)points,P<0.05.There was no significant difference in total incidence of complications between the two groups within 1 month after surgery(P>0.05).Conclusions Compared with incision and hanging put-aside drainage,incision and hanging wire-to-port drainage can promote wound healing,shorten hospitalization time,relieve postoperative pain and improve anal function in patients with perianal abscess,with certain safety.

关 键 词：脓肿 肛周 切开挂线对口引流术 切开挂线旷置引流术 临床疗效 

分 类 号：R657.15[医药卫生—外科学]