三间隙引流术对高位肛周脓肿病人肛门功能、创面愈合及血清激活素A水平的影响  

Impacts of three space drainage on anal function,wound healing and serum ACTA level in patients with high perianal abscess

作　　者：赵璐[1] 孙兴伟 王婷婷 陈怡 ZHAO Lu;SUN Xingwei;WANG Tingting;CHEN Yi(TCM Department of Anorectal Diseases,Northwest University First Hospital,Xi'an,Shaanxi 710043,China;Department of Anorectal Diseases,Xi'an Traditional Chinese Medicine Hospital,Xi'an,Shaanxi 710000,China;Department of General Surgery,Xi'an Chang'an District Hospital,Xi'an,Shaanxi 710000,China)

机构地区：[1]西北大学第一医院中医肛肠科,陕西西安710043 [2]西安市中医院肛肠科,陕西西安710000 [3]西安市长安区医院普通外科,陕西西安710000

出　　处：《安徽医药》2025年第3期596-599,共4页Anhui Medical and Pharmaceutical Journal

基　　金：陕西省重点研发计划项目(2022SF-369)。

摘　　要：目的探究三间隙引流术对高位肛周脓肿病人肛门功能、创面愈合及血清激活素A(ACTA)水平的影响。方法纳入西北大学第一医院2020年10月至2022年10月收治的48例高位肛周脓肿病人,依照治疗方案分为研究组和对照组,各24例。对照组病人行传统切开引流术,研究组行三间隙引流术。比较两组病人创面愈合时间、住院时间、术后视觉模拟评分法(VAS)评分及术后肛门功能;比较两组病人手术前后血清炎症因子、疼痛因子及ACTA水平变化。结果研究组术后创口愈合时间[(18.25±2.36)d比(22.25±3.12)d]、住院时间均较对照组缩短(均P<0.05);研究组术后7 d VAS评分低于对照组(P<0.05)。协方差主体间效应检验显示,研究组病人血清5-羟色胺(5-HT)、去甲肾上腺素(NE)水平较对照组降低(均P<0.05);术后7 d研究组Wexner量表评分[(7.07±0.97)分比(9.47±1.49)分]低于对照组(P<0.05)。术后7 d研究组血清白细胞介素(IL)-1β、C反应蛋白(CRP)、IL-6、肿瘤坏死因子α(TNF-α)、ACTA[(8.07±1.07)μg/L比(13.08±1.07)μg/L]水平较对照组降低(均P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论三间隙引流术创面小,可有效缓解病人疼痛,减轻炎症反应,降低ACTA水平及相关并发症发生率,保留肛门功能,改善病人术后生活质量。Objective To explore the impact of three space drainage on anal function,wound healing and serum activin A(ACTA)level in patients with high perianal abscess.Methods Forty-eight patients with high perianal abscess admitted to Northwest University First Hospital from October 2020 to October 2022 were included and assigned,according to the treatment plan,into a study group and a control group,each with 24 cases.Patients in the control group received conventional incision and drainage,while patients in the study group received three space drainage.A comparison was made of the wound healing time,hospitalization time,postoperative visual analogue scale(VAS)score and postoperative anal function between the two groups;the levels of serum inflammatory factors,pain factors and ACTA were compared between the two groups before and after surgery.Results The wound healing time[(18.25±2.36)d vs.(22.25±3.12)d]and hospital stay in the study group were shorter than those in the control group(both P<0.05);the VAS score of the study group on the 7th day after surgery was significantly lower than that of the control group(P<0.05).The covariance inter subject effect test results showed that the levels of serum serotonin(5-HT)and norepinephrine(NE)in the study group were significantly lower than those in the control group(both P<0.05);on the 7th day after surgery,the Wexner scale score in the study group was lower than that in the control group[(7.07±0.97)points vs.(9.47±1.49)points,P<0.05].The levels of serum interleukin-1β(IL-1β),Creactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and ACTA[(8.07±1.07)μg/L vs.(13.08±1.07)μg/L]in the study group were lower than those in the control group 7 days after surgery(all P<0.05);there was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Three space drainage has small wound,which can effectively relieve the pain of patients,reduce the incidence of inflammatory reaction and related c

关 键 词：肛周脓肿 三间隙引流术 肛门功能 创面愈合 激活素A 

分 类 号：R657.15[医药卫生—外科学]