LIFT改良术与传统肛瘘切除术治疗肛瘘的效果观察  

Observation on the effect of modified LIFT surgery and traditional anal fistula resection in the treatment of anal fistulas

作　　者：孔伟博 李会力 张定喜 KONG Weibo;LI Huili;ZHANG Dingxi(Department of General Surgery,Xuchang People's Hospital,Xuchang 461000,China)

机构地区：[1]许昌市人民医院普外科,河南许昌461000

出　　处：《黑龙江医药科学》2025年第3期68-71,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省医学科技攻关联合共建项目,编号:LHGJ20192181。

摘　　要：目的:探究括约肌间瘘管结扎(LIFT)改良术与传统肛瘘切除术在肛瘘治疗中的应用价值。方法:回顾性选取2021年5月至2023年8月许昌市人民医院114例肛瘘患者临床资料,根据手术方法不同分为改良组(n=55)和常规组(n=59)。改良组行LIFT改良术,常规组行传统肛瘘切除术。比较两组手术相关指标、手术前后应激因子[C反应蛋白(CRP)、趋化因子5(CCL5)、前列腺素E2(PGE2)]水平、肠道菌群(双歧杆菌、大肠杆菌、肠球菌)、Wexner评分及并发症情况。结果:改良组手术时间、创面愈合时间、住院时间均短于常规组,瘢痕面积小于常规组,术后1 d疼痛评分低于常规组(P<0.05);术后1 d、3 d,改良组血清CRP、CCL5、PGE2水平低于常规组(P<0.05);术后1 d、3 d,改良组双歧杆菌水平高于常规组,大肠杆菌、肠球菌低于常规组(P<0.05);术后1个月、3个月改良组Wexner评分低于常规组(P<0.05);两组并发症发生率比较,无显著差异(P>0.05)。结论:LIFT改良术治疗肛瘘能优化手术流程,增强临床疗效,改善患者早期预后,且远期预后、安全性和传统肛瘘切除术一致。Objective:To explore the application value of modified ligation of intersphincteric fistula tract(LIFT)and traditional anal fistula resection in the treatment of anal fistulas.Methods:A retrospective analysis was conducted on the clinical data of 114 patients with anal fistulas treated at Xuchang People's Hospital from May 2021 to August 2023.The patients were divided into modified group(n=55)and traditional group(n=59)based on the surgical method.The modified group underwent modified LIFT,while the conventional group underwent traditional anal fistula resection.The surgical indicators,levels of stress factors[C-reactive protein(CRP),chemokine ligand 5(CCL5)and prostaglandin E2(PGE2)],intestinal flora(Bifidobacterium,Escherichia coli and Enterococcus),Wexner scores and complications before and after surgery were compared between the two group.Results:The modified group had shorter operation times,wound healing times,and hospital stays,a smaller scar area,and a lower pain score on the first day after surgery compared with the traditional group(P<0.05).At 1 and 3 days postoperatively,the levels of serum CRP,CCL5 and PGE2 were lower in the modified group than in the traditional group(P<0.05).At 1 and 3 days postoperatively,the levels of Bifidobacterium were higher,while the levels of Escherichia coli and Enterococcus were lower in the modified group compared with the traditional group(P<0.05).The Wexner scores were lower in the modified group than in the traditional group at 1 and 3 months postoperatively(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Modified LIFT surgery for the treatment of anal fistulas can optimize the surgical procedure,enhance clinical efficacy,and improve early prognosis.The long-term prognosis and safety are consistent with those of traditional fistulectomy.

关 键 词：肛瘘 肌间瘘管结扎改良术 肛瘘切除术 应激因子 肠道菌群 并发症 Wexner评分 

分 类 号：R657.16[医药卫生—外科学]