改良Hanley术联合拖线疗法治疗坐骨直肠间隙肛周脓肿临床观察  

Effect of Modified Hanley Operation and Thread Dragging Therapy on Ischial Rectal Fossa Abscess

作　　者：关蕾 桂恒 余国庆 陈维天 石春雷 GUAN Lei;GUI Heng;YU Guoqing;CHEN Weitian;SHI Chunlei(Wuhu Hospital of Traditional Chinese Medicine,Wuhu 241000,Anhui,China;Wuhu Conch Hospital,Wuhu 241000,Anhui,China)

机构地区：[1]芜湖市中医医院,安徽芜湖241000 [2]芜湖海螺医院,安徽芜湖241000

出　　处：《辽宁中医杂志》2024年第12期116-119,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：芜湖市“华佗计划”卫生高层次人才分层培养;芜湖市科技计划项目(2022cg39)。

摘　　要：目的分析坐骨直肠间隙肛周脓肿患者采用改良Hanley术联合拖线疗法治疗的临床疗效。方法选取坐骨直肠间隙肛周脓肿患者80例,随机分为观察组(改良Hanley术联合拖线疗法)和对照组(切开内口挂线疗法),每组40例。分别采用视觉模拟评分(visual analogue scale,VAS)、Wexner量表、健康调查简表(the MOS item short from health survey,SF-36)评价疼痛、肛门功能和生活质量比较两组患者治疗后的创面面积、治疗效果、肛门功能、生活质量、切口愈合时间和术后住院时间、术后后遗症。结果与对照组比较,观察组术后7 d、21 d创面面积较小;观察组术后3 d、7 d患者VAS评分、创面分泌物评分、创面肿胀度评分较低,肉芽生长情况评分较高;术后7、28 d Wexner量表评分较低;术后7 d的SF-36评分较高;切口愈合时间较短,组间差异均有统计学意义(P<0.05)。观察组后遗症发生率为5.0%(2/40),低于对照组的22.5%(9/40)(P<0.05)。其余指标差异无统计学意义(P>0.05)。结论接受改良Hanley术联合拖线疗法可减轻坐骨直肠间隙肛周脓肿患者术后创面疼痛,缩短愈合时间,提高术后生活质量,减少后遗症的发生。Objective To evaluate the clinical efficacy of modified Hanley operation and thread dragging therapy in the treatment of patients with perianal abscess in the sciorectal space.Methods Eighty patients with perianal abscess in the sciorectal space were selected and randomly divided into observation group and control group with 40 patients in each group.The observation group were treated with modified Hanley operation and thread dragging therapy,while the control group were treated with incisional endogastric hanging therapy.Visual analogue scale(VAS),Wexner scale and the MOS item short from health survey(SF-36)were used to evaluate the pain,anal function and quality of life,respectively.The trauma area,treatment effect,anal function,quality of life,wound healing time and postoperative length of stay,and postoperative complications were compared between the two groups.Results Compared with those in the control group,the trauma areas at 7 d and 21 d after surgery were smaller.The VAS score,wound secretion score and wound swelling score were lower,and the granulation growth score was higher at 3 d and 7 d after surgery.Wexner scores of 7 d and 28 d after surgery were lower.The SF-36 score of 7 d after surgery was higher.The wound healing time was shorter,and the differences between the two groups were statistically significant(P<0.05).The incidence of sequelae in the observation group was 5.0%(2/40),which was lower than that in the control group of 22.5%(9/40)(P<0.05).The other indexes were similar(P>0.05).Conclusion Modified Hanley operation and thread dragging therapy can minimize postoperative trauma pain,shorten healing time,improve postoperative quality of life for patients,and lower the incidence of sequelae.

关 键 词：坐骨直肠间隙肛周脓肿 改良Hanley术 拖线疗法 生活质量 

分 类 号：R266[医药卫生—中医外科学]