摘要
目的:通过对低位切开留皮桥高位挂线治疗高位肛门直肠瘘的研究,建立高位肛门直肠瘘诊疗规范及手术模式,减少术后肛门变形,减少肛门功能的损伤,缩短治疗疗程,降低术后复发率,降低医疗费用,使医疗资源得到充分利用。方法:对80例高位肛门直肠瘘患者按随机数字表分成两组,治疗组40例,对照组40例。治疗组手术方式采用低位切开留皮桥高位挂线的手术方式治疗;对照组手术方式采用低位切开高位挂线的手术方式治疗。观察两组患者术后创面最大变形宽度、创面愈合时间、肛门压力测定值、肛门功能(漏气、漏液、漏便情况)情况。结果:治疗组的术后创面最大变形宽度、创面愈合时间明显优于B组,差异显著(P<0.01),治疗组在创面愈合后出现肛门漏气、漏液、漏便病例明显少于B组,差异显著(P<0.01);两组术后肛门压力测定值有明显差异(P<0.01)。结论:针对高位肛门直肠瘘患者,依据患者病情选用低位切开留皮桥高位挂线术式,相比于采用传统术式,效果更为确切,治疗组创面愈合时间明显缩短,术后第3天、第7天、第14天、第21天创面最大变形宽度明显缩小;在对术后括约肌的影响中,由于肛门形态的维护,低位切开留皮桥高位挂线术式对保护肛门括约肌更优于传统术式,对肛门功能的影响降到最低,在临床中具有推广价值。
Objective:To establish a high-grade anorectal fistula to reduce the postoperative anal deformation,reduce the injury of theanus function,and shorten the treatment course.Methods:80patients were divided into two group,40cases in the treatment group and40cases in the control group.In the treatment group,the operation mode was treated by low-level incision and maintenance of the high-lyingskin grafts.Results:The maximal deformation width and wound healing time of the treatment group were significantly better than those ofthe control group(P<0.01).The treatment group had an anal leakage and leakage in the treatment group(P<0.01).There was significantdifference between two groups(P<0.01).Conclusion:The treatment of high anus and rectal fistula patients,according to the patient’scondition selection of low incision leftover bridge high hanging line surgery,compared to the traditional surgery,the effect is more accurate,wound healing time was significantly shorter.
出处
《中医临床研究》
2017年第12期112-114,共3页
Clinical Journal Of Chinese Medicine
基金
福建省卫生厅中医药临床基地课题(No.zlcgc01)
关键词
高位肛门直肠瘘
低位切开
留皮桥
高位挂线术式
临床研究
High anorectal fistula
Low incision
Skin bridge
High hanging line surgery
Clinical research
