瘘管隧道法切除一期缝合术治疗肛瘘的疗效观察  

Observation of therapeutic effects of fistulectomy with tunnel resectional therapy and primary suture in the treatment of anal fistula.

作　　者：杜卫东[1] 郑卫平[1] 袁祖荣[1] 杨俭英[2] 

机构地区：[1]上海华东医院普外科,200040 [2]上海华东医院信息科,200040

出　　处：《中国实用外科杂志》2002年第12期727-729,共3页Chinese Journal of Practical Surgery

摘　　要：目的　观察和评估瘘管隧道法切除一期缝合术治疗肛瘘的临床疗效。方法　将 194例肛瘘病人随机分成 :瘘管隧道法切除一期缝合术组 (TRFS组 ,68例 )、肛瘘切除缝合术组 (FS组 ,64例 )和肛瘘切除术组 (F组 ,62例 )。观察三组病例创面愈合时间 ,术后伤口感染情况 ,监测术后疤痕大小 ,肛门变形情况和肛门括约肌功能 ,随访术后 2年内的复发情况。结果　TRFS组和FS组术后创面愈合时间较F组明显缩短 (P <0 0 5 ) ,术后的疤痕小 (P <0 0 5 ) ,FS组术后伤口感染率和复发率较其它两组高 (P <0 0 5 ) ,TRFS组和FS组术后肛门变形的病例很少 (P <0 0 5 ) ,TRFS组和FS组术后均未出现肛门括约肌损伤引起大便失禁的病例。结论　瘘管隧道法切除一期缝合术既能达到根治肛瘘的目的 ,又最大限度地保护了肛门括约肌的功能 ,创面愈合时间短 ,术后疤痕小 ,手术复发率低 。Objective To observe and assess the therapeutic effects of fistulectomy with tunnel resectional therapy and primary suture in the treatment of anal fistula. Methods One hunderd and ninety-four cases of anal fistula were divided into 3 groups in a randomized control study:the fistulectomy with tunnel resectional therapy and primary suture group(Group TRFS),the fistulectomy and primary suture group (Group FS) and the fistulectomy group(Group F). Observe and assess the length of the healing time,the size of the scar,the anal disformation,the function of the anal sphincter,the infection rate and the relapse rate in 2 years.Results The healing time in Group TRFS and Group FS was much shorter than it in Group F(P<0 05).The sizes of scars in Group TRFS and Group FS were much smaller than those in Group F(P<0 05).The infection rate and the recurrent rate were much higher in Group FS than those in the other groups(P<0 05).There were fewer cases of anal disformation in Group TRFS and Group FS.And there was no anal sphincter disfunction in Group TRFS and Group FS.Conclusion The method could not only cure the anal fistula radically but also protect the anal sphincter best.It is the best way to treat anal fistula with small scar,quick healing and low recurrence rate.

关 键 词：肛瘘 隧道切除术 肛瘘切除缝合术 治疗 

分 类 号：R657.140.5[医药卫生—外科学]