合并HIV/AIDS的高位复杂性肛瘘治疗研究  

Study on the treatment of high-complexity anal fistula complicated with HIV/AIDS

作　　者：陈翔 CHEN Xiang(Department of General Surgery,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine(Nanjing Second Hospital),Nanjing 210037,China)

机构地区：[1]南京中医药大学附属南京医院(南京市第二医院)普通外科,210037

出　　处：《中国实用医药》2025年第5期58-60,共3页China Practical Medicine

摘　　要：目的评价合并人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)的高位复杂性肛瘘的手术治疗效果。方法29例合并HIV/AIDS的高位复杂性肛瘘患者,27例行改良切开挂线对口引流术,2例行高位旷置引流+负压吸引术,术后采用复方黄柏涂剂坐浴联合百克瑞纱布敷料外用。观察患者术后住院时间、愈合时间、复发情况、肛门功能及生活质量。结果29例患者术后住院时间为6~21 d,平均术后住院时间为(10.41±3.24)d,平均愈合时间为(35.69±12.56)d,术后随访6个月无复发。Williams肛门功能分级:29例患者术前Williams分级均为A级,至随访结束,29例患者Williams分级仍为A级。所有患者均未发生肛门失禁情况。平均生活质量评分为(80.9±5.6)分,术后生活质量良好。结论对合并HIV/AIDS的高位复杂性肛瘘患者采用改良切开挂线对口引流术或高位旷置+负压吸引术治疗可有效保护肛门功能,提高生活质量。但要注意术前高效抗逆转录病毒治疗及对围手术期合并症的预防和处理。Objective To evaluate the surgical treatment effect of high-complexity anal fistula complicated with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS).Methods Among the 29 patients with high-complexity anal fistula complicated with HIV/AIDS,27 cases underwent modified incision and thread-drawing drainage,and 2 cases underwent high open drainage+negative pressure attraction,and compound Huangbai Liquid sitting bath combined with Baikerui gauze dressing was used after surgery.The length of hospital stay,healing time,recurrence,anal function and quality of life were observed.Results The hospitalization time of the 29 patients was 6-21 d,the mean postoperative hospitalization time was(10.41±3.24)d,the mean healing time was(35.69±12.56)d,and there was no recurrence after 6 months of follow-up.Williams anal function grading:all 29 patients in Williams grade A before surgery,and by the end of follow-up,29 patients still in Williams grade A.None of the patients had anal incontinence.The average quality of life score was(80.9±5.6)points,and the postoperative quality of life was good.Conclusion For patients with high-complexity anal fistula complicated with HIV/AIDS,modified incision and thread-drawing drainage or high open drainage+negative pressure attraction can effectively protect anal function and improve quality of life.However,attention should be paid to preoperative highly effective antiretroviral therapy and the prevention and management of perioperative comorbidities.

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 高位复杂性肛瘘 切开挂线对口引流术 复方黄柏涂剂 百克瑞纱布敷料 

分 类 号：R65[医药卫生—外科学]