保留括约肌内口切除引流术治疗复杂性肛瘘的临床效果  

Clinical Study on the Treatment of Complex Anal Fistula with Preservation of Internal Sphincter Excision and Drainage Surgery

作　　者：王晓斌 WANG Xiaobin(Department of Interventional Vascular Surgery,Ganzhou District People's Hospital,Zhangye,Gansu 734000)

机构地区：[1]甘肃省张掖市甘州区人民医院泌尿肛肠血管介入外科,甘肃张掖734000

出　　处：《智慧健康》2025年第2期63-66,共4页Smart Healthcare

摘　　要：目的探讨在复杂性肛瘘患者中采用保留括约肌内口切除引流术所取得的临床疗效。方法选取2023年3月—2024年3月本院收治的82例复杂性肛瘘患者选为研究对象,随机将其分为两组,每组41例。对照组采用肛门括约肌间瘘管结扎术;观察组采用保留括约肌内口切除引流术,比较两组的临床效果、肛门功能、住院时长、创面愈合时间、卧床时长和疼痛程度。结果相较于对照组,观察组治疗总有效率更高(P<0.05)。术后1个月,两组Wexner肛门失禁评分均较之术前降低,且观察组低于对照组(P<0.05)。观察组创面愈合时间、住院时间、卧床时间均短于对照组(P<0.05)。术后24 h、3 d和7 d,两组VAS评分均呈下降趋势,且观察组低于对照组(P<0.05)。结论在复杂性肛瘘患者中采用括约肌内口切除引流术,可缩短患者住院时间、卧床时间和疼痛持续时间,同时能加速创面愈合和改善肛门功能,获得显著疗效。Objective To explore the clinical effect of preserving the internal opening of the anal sphincter for the treatment of complex anal fistula patients.Methods The study selected 82 patients with complex anal fistula admitted to our hospital from March 2023 to March 2024,and the 82 patients were divided into 2 groups,each group was 41 patients.Anal sphincter fistula ligation was used in control group,and the observation group was treated with preservation of the internal opening of the anal sphincter resection and drainage.Compare the clinical outcomes,anal function,length of hospital stay,wound healing time,length of bed rest,and degree of pain between the 2 groups.Results Compared with the control group's 78.05%,the observation group's 95.12%total effective rate was higher(P<0.05).Before surgery,the Wexner anal incontinence scores for the observation group and the control group were(14.36±2.28)and(16.33±2.26)points,respectively.One month after surgery,the scores were(3.56±0.72)and(5.28±0.97)points,respectively;The Wexner anal incontinence scores of both groups decreased one month after surgery compared to before surgery,and the observation group had a lower score(P<0.05).Compared with the control group,The length of hospital stay,bed rest time,and wound healing time in observation group were shorter(P<0.05).Compared with the control group,at 24 hours,3 days,and 7 days after surgery,the visual analog scale(VAS)scores of the observation group were lower(P<0.05).Conclusion The application of sphincter preserving resection and drainage surgery for complex anal fistula patients can shorten the length of hospital stay,bed rest time,and pain duration,accelerate wound healing,and improve anal function,with significant therapeutic effects.

关 键 词：视觉模拟评分法 保留括约肌内口切除引流术 复杂性肛瘘 肛门括约肌间瘘管结扎术 肛门功能 

分 类 号：R65[医药卫生—外科学]