双向等压引流术与低位切开高位挂线治疗复杂性肛瘘疗效比较  

Comparison of Therapeutic Effects Between Bidirectional Isobaric Drainage and Low Incision and High Thread Hanging in the Treatment of Complex Anal Fistula

作　　者：张强 谢彦春 ZHANG Qiang;XIE Yan-chun(General Surgery,Yulin Yuyang District Hospital of Traditional Chinese Medicine,Shaanxi Yulin 719000,China)

机构地区：[1]榆林市榆阳区中医医院普通外科,陕西榆林719000

出　　处：《中华养生保健》2024年第11期175-178,共4页CHINESE HEALTH CARE

摘　　要：目的比较双向等压引流术与低位切开高位挂线治疗复杂性肛瘘的疗效。方法选择2019年1月—2022年12月榆林市榆阳区中医医院治疗的70例复杂性肛瘘患者作为研究对象,根据患者治疗术式不同将其分为试验组和常规组,每组35例。试验组采取双向等压引流术治疗,常规组采取低位切开高位挂线治疗,比较两组患者治疗效果、创面愈合时间、术后1 d、3 d、7 d肛门疼痛情况、术前及术后5 d、1月、3月肛门功能情况。结果两组治疗效果比较,差异无统计学意义(P>0.05)。试验组患者术后住院时长及创面愈合时长均短于常规组,差异有统计学意义(P<0.05)。术后1 d、3 d、7 d,两组患者疼痛评分均逐渐下降,试验组各时间点评分均低于常规组,差异有统计学意义(P<0.05)。术后5 d,两组Wexner评分均上升,术后1月、3月随时间推移评分逐渐下降,组间比较,试验组在术后5 d、1月、3月评分均低于常规组,差异有统计学意义(P<0.05)。结论双向等压引流术与低位切开高位挂线治疗复杂性肛瘘疗效相当,但双向等压引流术造成疼痛更低,愈合时间更短,且会有效保护肛门括约肌功能,防止肛门失禁的发生。Objective To compare the efficacy of bidirectional isobaric drainage and low incision and high thread-drawing in the treatment of complex anal fistula.Methods From January 2019 to December 2022,70 patients with complex anal fistula treated in Yuyang District Hospital of Yulin City were selected as the research object,according to the different treatment methods of patients,they were divided into experimental group and conventional group,with 35 patients in each group.The experimental group adopted bidirectional isobaric drainage treatment,the conventional group adopted low incision and high hanging line treatment.The treatment effect,wound healing time,anal pain,1 d,3 d,7 d,and anal function,5 d,1 and 3 month were compared between the two groups.Results There was no significant difference between the experimental group and the routine group(P>0.05).The length of postoperative hospital stay and wound healing in the experimental group were shorter than those in the routine group,and the difference was statistically significant(P<0.05).On the 1st,3rd and 7th day after operation,the VAS scores of patients in the two groups decreased gradually,and the scores in the experimental group were lower than those in the routine group,with statistical significance(P<0.05).On 5th postoperative day,the scores of Wexner in both groups increased,and gradually decreased in January and March after operation.Compared between groups,the scores in the experimental group were lower than those in the routine group on 5th postoperative day,January and March,and the difference was statistically significant(P<0.05).Conclusion Bi-directional isobaric drainage is as effective as low incision and high thread-drawing in the treatment of complex anal fistula,but it causes lower pain and faster healing time,and can effectively protect the function of anal sphincter and prevent anal incontinence.

关 键 词：双向等压引流术 低位切开高位挂线 复杂性肛瘘 Wexner评分 

分 类 号：R657.16[医药卫生—外科学]