瘘管旷置术配合切开挂线疗法用于复杂性肛瘘治疗的临床效果及复发情况分析  

Analysis of the Clinical Effect and Recurrence of Fistula Exclusion Combined with Incision and Thread-drawing Therapy in the Treatment of Complex Anal Fistula

作　　者：王海滨 WANG Haibin(Department of Surgery,Yantai City Municipal Government Hospital,Yantai 264000,Shandong,China)

机构地区：[1]烟台市市直机关医院外科,山东烟台264000

出　　处：《中外医疗》2024年第24期5-9,共5页China & Foreign Medical Treatment

摘　　要：目的 分析复杂性肛瘘治疗中应用瘘管旷置术配合切开挂线疗法的临床效果以及复发率情况。方法随机选取2021年1月—2022年12月烟台市市直机关医院收治的80例复杂性肛瘘患者为研究对象,依据手术方案的不同将其分为对照组与观察组,各40例。对照组应用单纯切开挂线疗法,观察组联合应用瘘管旷置术。评价两组患者的治疗效果与复发率、治疗指标、术后疼痛、睡眠情况、创面渗液情况。结果 观察组治疗有效率为97.50%(39/40),高于对照组的75.00%(30/40),差异有统计学意义(χ^(2)=8.538,P=0.003),观察组的手术时间长于对照组,术后下床时间、住院时间、创面愈合时间短于对照组,术中失血量高于对照组,差异有统计学意义(P均<0.05)。术后3 d、5 d和7 d,观察组的疼痛评分和睡眠质量评分低于对照组,差异有统计学意义(P均<0.05)。术后3 d、5 d和7 d,观察组的创面渗液评分低于对照组,差异有统计学意义(P均<0.05)。结论 复杂性肛瘘治疗中应用瘘管旷置术配合切开挂线疗法有助于减少患者手术造成的肛周损伤,提升治疗效果,减少术后疼痛与睡眠影响,且降低患者的复发率。Objective To analyze the clinical efficacy and recurrence rate of fistula exclusion combined with incision and thread-drawing therapy in the treatment of complex anal fistula.Methods A total of 80 patients with complex anal fistula admitted to Yantai City Municipal Government Hospital from January 2021 to December 2022 were radomly selected as the research objects.According to the different surgical schemes,they were divided into control group and observation group,with 40 cases in each group.The control group was treated with simple incision and thread-drawing therapy,and the observation group was combined with fistula exclusion.The therapeutic effect,recurrence rate,treatment index,postoperative pain,sleep and wound exudate of the two groups were evaluated.Results The effective rate of treatment in the observation group was 97.50%(39/40),which was higher than 75.00%(30/40)in the control group,the difference was statistically significant(χ^(2)=8.538,P=0.003).The operation time in the observation group was longer than that of the control group,the postoperative ambulation time,hospitalization time and wound healing time of the observation group were shorter than those of the control group,and the intraoperative blood loss was higher than that of the control group,the differences were statistically significant(all P<0.05).On the 3 day,5 day and 7 day after operation,the pain score and sleep quality score of the observation group were lower than those of the control group,and the differences were statistically significant(all P<0.05).On the 3 day,5 day and 7 day after operation,the wound exudate score in the observation group was lower than that in the control group,and the difference was statistically significant(all P<0.05).Conclusion The application of fistula exclusion combined with incision and thread-drawing therapy in the treatment of complex anal fistula is helpful to reduce the perianal injury caused by surgery,improve the therapeutic effect,reduce postoperative pain and sleep,and reduce the recurrence ra

关 键 词：瘘管旷置术 复杂性肛瘘 切开挂线疗法 复发率 术后疼痛 

分 类 号：R657.16[医药卫生—外科学]