一次性瘘管圈套器定向挂线治疗高位肛瘘的临床效果观察  

Observation of the clinical efficacy of disposable fistula snares in the treatment of high anal fistula

作　　者：钟明利 路越[2] Zhong Mingli;Lu Yue(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Department of Hemorrhoids and FistulaⅢ,The Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110003,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第三医院痔瘘三科,辽宁沈阳110003

出　　处：《结直肠肛门外科》2024年第4期465-470,共6页Journal of Colorectal & Anal Surgery

摘　　要：目的观察一次性瘘管圈套器定向挂线治疗高位肛瘘的临床疗效。方法选取2022年10月至2023年10月辽宁中医药大学附属第三医院收治的60例高位肛瘘患者作为研究对象,按照随机数字表法将其分成治疗组(n=30,采用一次性瘘管圈套器定向挂线治疗)和对照组(n=30,采用低切高挂术治疗)。观察记录两组的临床疗效、橡皮筋或弹力线脱落时间、手术时间、创面愈合时间、疼痛程度视觉(模拟评分法)及肛门功能(术前和术后3个月的Wexner肛门失禁评分、肛管静息压及肛管最大收缩压)和复发情况。结果两组治疗总有效率(100%vs.90%)、橡皮筋或弹力线脱落时间、复发率(3.33%vs.10%)比较差异无统计学意义(P>0.05);治疗组的手术时间及创面愈合时间短于对照组(P<0.05)。术后第1天,两组视觉模拟评分比较差异无统计学意义(P>0.05);术后第7天,两组视觉模拟评分均降低,且治疗组的视觉模拟评分低于对照组(P<0.05)。术前,两组Wexner肛门失禁评分、肛管静息压及肛管最大收缩压比较差异无统计学意义(P>0.05)。术后3个月,两组Wexner肛门失禁评分均高于术前,肛管静息压及肛管最大收缩压均低于术前(P<0.05);治疗组Wexner肛门失禁评分低于对照组,肛管静息压及肛管最大收缩压高于对照组(P<0.05)。结论采用一次性瘘管圈套器定向挂线治疗高位肛瘘,在保证疗效的同时,可以维护肛门精细功能,保护肛门括约肌功能,减少肛门“锁眼样”畸形等并发症,且便捷了紧线流程,减轻了患者术后紧线的疼痛,具有一定临床推广应用的价值。Objectives To observe the clinical efficacy of disposable fistula snares in the treatment of high anal fistula.Methods A total of 60 patients with high anal fistula admitted to the Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the study subjects,and they were divided into treatment group(n=30,treated with disposable fistula snares)and control group(n=30,treated with low-cut and high-hanging)according to the random number table method.The clinical efficacy,time of rubber band or elastic line shedding,operation time,wound healing time,pain level[visual analogue scale(VAS)],anal function[Wexner anal incontinence score,anal resting pressure(ARP)and anal maximal contraction pressure(AMCP)]before and 3 months after surgery and recurrence were observed and recorded in the two groups.Results There were no significant differences in the total effective rate(100%vs.90%),time of rubber band or elastic line shedding,and recurrence rate(3.33%vs.10%)between the two groups(P>0.05).The operation time and wound healing time of the treatment group were shorter than those of the control group(P<0.05).There was no significant difference in VAS score between the two groups on the first day after operation(P>0.05).On the 7th day after surgery,the VAS scores of both groups were decreased,and the VAS scores of the treatment group were lower than those of the control group(P<0.05).Before surgery,there was no significant difference in Wexner anal incontinence score,ARP and AMCP between the two groups(P>0.05).At 3 months after surgery,the Wexner anal incontinence score in both groups was higher than that before surgery,and the ARP and AMCP were lower than those before surgery(P<0.05).The Wexner anal incontinence score in the treatment group was lower than that in the control group,and the ARP and AMCP were higher than those in the control group(P<0.05).Conclusion The use of disposable fistula snares for the treatment of high anal fistula can main-tain the

关 键 词：高位肛瘘 一次性瘘管圈套器 定向挂线 肛门功能 

分 类 号：R657.1[医药卫生—外科学]