括约肌间瘘管结扎术联合瘘管隧道式切除术治疗低位肛瘘患者的效果  

Effects of ligation of intersphincteric fistula combined with fistula tunnel resection in treatment of patients with low anal fistula

作　　者：刘俊 林成章 LIU Jun;LIN Chengzhang(Anorectal Department of Luoyuan County Hospital,Fuzhou 350600 Fujian,China)

机构地区：[1]罗源县医院肛肠科,福建福州350600

出　　处：《中国民康医学》2025年第4期54-57,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察括约肌间瘘管结扎术联合瘘管隧道式切除术治疗低位肛瘘患者的效果。方法:回顾性分析2021—2023年该院收治的109例低位肛瘘患者的临床资料,依据手术方案不同将其分成对照组54例与研究组55例。对照组行瘘管切开术治疗,研究组行肌间瘘管结扎术联合瘘管隧道式切除术治疗,比较两组创面愈合时间、住院时间、术后疼痛程度[疼痛数字评分法(NRS)]评分、手术前后肛门功能指标[直肠静息压(ACRP)、肛管最大收缩压(AMCP)、肛管静息压(ARP)、肛门失禁(Wexner)评分]水平和术后并发症发生率。结果:研究组创面愈合时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后1、2、5 d,研究组NRS评分均低于对照组,差异有统计学意义(P<0.05);术后12周,两组ACRP、AMCP、ARP水平及Wexner评分均低于术前,且研究组Wexner评分低于对照组,但研究组ACRP、AMCP、ARP水平高于对照组,差异有统计学意义(P<0.05);研究组术后并发症发生率为3.64%,低于对照组的16.67%,差异有统计学意义(P<0.05)。结论:肌间瘘管结扎术联合瘘管隧道式切除术治疗低位肛瘘患者可缩短创面愈合时间和住院时间,改善肛门功能指标水平,以及降低疼痛程度评分和术后并发症发生率的效果优于瘘管切开术治疗。Objective:To observe effects of ligation of intersphincteric fistula combined with fistula tunnel resection in treatment of patients with low anal fistula.Methods:The clinical data of 109 patients with low anal fistula admitted to this hospital from 2021 to 2023 were retrospectively analyzed.According to different surgical schemes,they were divided into control group(54 cases)and study group(55 cases).The control group was treated with fistulotomy,while the study group was treated with ligation of intermuscular fistula combined with fistula tunnel resection.The wound healing time,the hospitalization time,the postoperative pain degree[numerical rating scale(NRS)]score,the anal function indexes[rectal resting pressure(ACRP),anal maximum contraction pressure(AMCP),anal resting pressure(ARP),anal incontinence score(Wexner)]levels before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:The wound healing time and the hospitalization time of the study group were shorter than those of the control group,and the difference was statistically significant(P<0.05).1,2 and 5 days after the surgery,the NRS scores of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).12 weeks after the surgery,the levels of ACRP,AMCP,ARP and Wexner score in the two groups were lower than those before the surgery,the Wexner score in the study group was lower than that in the control group,but the levels of ACRP,AMCP and ARP in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of postoperative complications in the study group was 3.64%,which was lower than 16.67%in the control group,the difference was statistically significant(P<0.05).Conclusions:Ligation of intermuscular fistula combined with fistula tunnel resection in the treatment of the patients with low anal fistula can shorten the wound healing time and the hospitalizati

关 键 词：低位肛瘘 括约肌间瘘管结扎术 瘘管隧道式切除术 瘘管切开术 肛门功能 疼痛 并发症 

分 类 号：R657.1[医药卫生—外科学]