指套内挂线术联合经括约肌间切开术治疗经括约肌型肛瘘的疗效  

Efficacy of intraphalanx hanging technique combined with transsphincterotomy in the treatment of transsphincteranal fistula

作　　者：张晓飞 卢彦 黄六胜 刘歆 张磊昌[3] ZHANG Xiaofei;LU Yan;HUANG Liusheng;LIU Xin;ZHANG Leichang(Department of Anorectal,Affiliated Ganzhou Hospital of Traditional Chinese Medicine,Jiangxi University of Chinese Medicine,Ganzhou 341000,CHINA)

机构地区：[1]江西中医药大学附属赣州市中医院肛肠科,江苏赣州341000 [2]于都县中医院肛肠科 [3]江西省中医院肛肠科

出　　处：《江苏医药》2024年第9期874-876,881,共4页Jiangsu Medical Journal

基　　金：国家自然科学基金项目(82260938);赣州市科技计划项目(20222ZDX8124)。

摘　　要：目的 观察指套内挂线术联合经括约肌间切开术治疗经括约肌型肛瘘的疗效。方法 60例经括约肌型肛瘘患者随机分为两组,每组30例。观察组采用指套内挂线术联合经括约肌间切开术,对照组采用传统肛瘘切开挂线术。比较两组患者术中手套破损率、术后VAS疼痛评分、愈合时间、术后并发症发生率及肛门功能。结果 观察组术中手套破损率、术后并发症发生率低于对照组,愈合时间短于对照组(P<0.05)。术后第3、7、14天,两组VAS疼痛评分低于术后第1天,且观察组低于对照组(P<0.01)。观察组术后肛管静息压、最大收缩压及耻骨直肠肌、肛门内括约肌、肛门外括约肌的动作电位平均时限高于对照组(P<0.05)。结论 指套内挂线术联合经括约肌间切开术治疗经括约肌型肛瘘,能够减轻术后疼痛,缩短愈合时间,减少并发症的发生,保护肛门功能。Objective To observe the efficacy of intraphalanx hanging technique combined with transsphincterotomy in the treatment of transsphincter anal fistula.Methods sSixty patients with transsphincter anal fistula were randomly divided into two groups with 30 cases each.Group A was treated with intraphalanx hanging technique combined with transsphincterotomy,and group B was treated with conventional anal fistula incision and hanging.The incidence of intraoperative glove breakage,postoperative VAS pain score,healing time,incidence of postoperative complications and anal function were compared between the two groups.Results The incidences of glove breakage and postoperative complications were lower,and the healing time was shorter in group A than those in group B(P<0.05).The VAS pain scores of the two groups were lower on the 3,7h and 14h day after surgery than those on the 1^(st)day after surgery,which were lower in group A than those in group B(P<0.01).The postoperative anal canal resting pressure,maximum systolic pressure and mean duration of action potential of puborectal muscle,internal anal sphincter and external anal sphincter were higher in group A than those in group B(P<0.05).Conclusion The intraphalanx hanging technique combined with transsphincterotomy in the treatment of transsphincter anal fistula can alleviate postoperative pain,shorten healing time,reduce complications and protect anal function.

关 键 词：指套内挂线术 经括约肌间切开术 肛瘘 肛门功能 

分 类 号：R657[医药卫生—外科学]