改良经肛门直肠黏膜瓣推移术治疗直肠黏膜下内口瘘疗效分析  

Efficacy Analysis of Modified Transanal Mucosal Flap Displacement in Treatment of Rectal Submucous Fistula

作　　者：罗明雷 卢红阳 马传玉 LUO Ming-lei;LU Hong-yang;MA Chuan-yu(Linyi Central Hospital,Linyi,Shandong 276400)

机构地区：[1]山东省临沂市中心医院,山东临沂276400

出　　处：《中国肛肠病杂志》2024年第6期36-38,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨分析改良经肛门直肠黏膜瓣推移术(ERAF)治疗直肠黏膜下内口瘘的临床疗效。方法:选取2021年6月至2023年6月,本院收治的62例直肠黏膜下内口瘘患者,随机分为观察组和对照组,每组各31例。观察组采用改良经肛门直肠黏膜瓣推移术治疗,对照组采用传统切开挂线术治疗。比较2组术后疼痛、首次排便时间、术后出血及感染等情况。结果:2组在术后首次排便时间、术中出血量、手术时间和尿潴留发生率方面比较,差异无统计学意义(P>0.05)。观察组一次性治愈率高于对照组(P<0.05),术后1d、7d和15d的疼痛VAS评分均低于对照组(P<0.05),术后出血、感染、肛门失禁发生率及复发率均低于对照组(P<0.05)。观察组创面愈合时间为(23.45±3.56)d,短于对照组的(36.28±5.58)d(P<0.05)。结论:改良ERAF术与传统切开挂线术治疗黏膜下内口瘘均疗效显著,但改良ERAF术能减轻患者术后疼痛,减少术后出血及肛门失禁发生率,缩短创面愈合时间,提高患者生活质量。Objective To investigate the clinical efficacy of modified endorectal advancement flap(ER-AF)in the treatment of rectal submucous fistula.Methods A total of 62 patients with rectal submucous fistula admitted to our hospital from June 2021 to June 2023 were randomly divided into observation group and control group,with 31 cases in each group.The observation group was treated with modified ERAF,while the control group was treated with traditional incision and thread-drawing surgery.Postoperative pain,first defecation time,intraoperative blood loss and infection were compared between the two groups.Results There were no significant differences in the first postoperative defecation time,intraoperative blood loss,operation time and incidence of urinary retention between the two groups(P>0.05).The one-time cure rate of the observation group was higher than that of the control group(P<0.05).The pain VAS scores of the observation group on the 1st,7th and 15th day after surgery were lower than those of the control group(P<0.05).The incidence of postoperative bleeding,infection,anal incontinence and recurrence rate of the observation group were lower than those of the control group(P<0.05).The wound healing time was(23.45±3.56)d in the observation group,which was shorter than(36.28±5.58)d in the control group(P<0.05).Conclusion Both modified ERAF and traditional incision and thread-drawing surgery are effective in the treatment of submucous fistula,but modified ERAF can relieve postoperative pain,reduce postoperative bleeding and incidence of anal incontinence,shorten wound healing time,and improve patients'quality of life.

关 键 词：直肠黏膜下瘘 改良经肛门直肠黏膜瓣推移术 疗效 

分 类 号：R657.1[医药卫生—外科学]