摘要
为比较经肛吻合器瘘管切除术和挂线疗法对直肠黏膜下瘘的临床疗效,将88例直肠黏膜下瘘患者分为对照组和观察组。对照组43例采用挂线疗法,观察组45例采用经肛门吻合器瘘管切除术。比较2组患者的术后疼痛VAS评分、肛管直肠动力学指标、治疗效果(治愈时间、治愈率、复发率)。结果显示,观察组患者术后疼痛VAS评分低于对照组(P<0.05)。术后2组患者通过肛管直肠动力学检测,肛管最大收缩压(AMCP)均较术前下降明显,术后1个月,观察组AMCP下降幅度明显,与对照组比较差异有统计学意义(P<0.05)。观察组治愈时间为(19.78±4.19)d,明显短于对照组的(28.04±9.55)d,差异有统计学意义(P<0.05)。术后半年治愈率比较,观察组为95.56%(43/45),明显高于对照组的81.40%(35/43)。术后2年复发率比较,观察组复发1例(2.33%),对照组复发4例(11.43%),但差异无统计学意义(P>0.05)。结果表明,经肛门吻合器瘘管切除术治疗直肠黏膜下瘘疗效显著,具有治愈率高、疼痛轻、复发率低、治愈时间短等优点,值得临床推广应用。
To compare the clinical effects of stapled transanal fistulectomy（STF） and thread-drawing ther- apy in the treatment of rectal submucous fistula, 88 patients with this fistula were divided into control group and observation one,which the former （ n=43） adopted thread-drawing therapy,meanwhile the latter（ n =45） received above STF;then both groups＇ VAS score on postoperative pain,the dynamics indexes of ano-reetum,and efficacy （curative time,curative rate and recurrence rate） were compared between the two groups.As results,the VAS score on postoperative pain in the latter was lower than that in the former （ P 〈0.05）;the AMCP measured by ano-rectal dynamics after surgery in the two groups was significantly decreased than before surgery,and at 1 month after surgery the decline in the latter was more significantly than that in the former,there was statistical difference compared with the former （ P （0.05）;in curative time and curative rate at 0.5 year after surgery,the latter was significantly shorter,higher than the former [（19.78±4.19） d vs （28.04±9.55） d, P 〈0.05;95.56%（43/45） vs 81.40%0（35/43）];at 2 years after sur- gery,in the former 4 cases suffered from recurrence [11.43 % （4/35）], in the latter 1 case from recurrence [2.33 % （1/43）], but this difference had no statistical significance（ P 〉0.05）.Results show that the proce- dure adopted by the latter for treating rectal submucous fistula has certain effect with such merits as high curative rate, mild pain,low recurrence rate,and short curative time,ere.It is worthy to be popularized and used clinically.
作者
刘鹏林
赵刚
邸爱婷
张立泽
王丹丹
LIU Peng-lin ,ZHAO Gang ,DI Ai-ting ,ZHANG Li-ze ,WANG Dan-dan(The Affiliated Hospital of Qingdao University ,Qingdao ,Shandong 26655)
出处
《中国肛肠病杂志》
2018年第1期11-14,共4页
Chinese Journal of Coloproctology
关键词
直肠黏膜下瘘
经肛吻合器瘘管切除术
疗效观察
Rectal submucous fistula
Stapled transanal fistulectomy
Effect observation
