摘要
目的探讨置管引流联合负压吸引治疗高位复杂性肛瘘的临床效果。方法回顾性分析上海中医药大学附属龙华医院2015年7月至2018年6月采用置管引流联合负压吸引法治疗的43例高位复杂性肛瘘患者的治愈率、术后创面愈合时间、复发率及Williams肛门功能等级。结果 43例研究对象术后创面一期愈合率为72.09%(31/43),创面平均愈合时间(47.41±18.39) d。12例患者术后三个月仍未愈合行第二次手术治疗,其中7例愈合、5例好转,总体愈合率为88.37%(38/43)。术后随访6～36个月,创面愈合患者均无复发。术后Williams肛门功能评级A级40例、B级3例。结论高位复杂性肛瘘采用瘘管深部腔隙置管引流联合负压吸引治疗可有效清除深部感染灶,具有良好的临床治疗效果。
Objectives To investigate the clinical effect of catheter drainage plus vacuum aspiration in treating high complex fistula. Methods This was a retrospective analysis of 43 patients with high complex fistula who were treated with catheter drainage plus vacuum aspiration at Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between July 2015 and June 2018. We analyzed their cure rate, time to postoperative wound healing, recurrence rate and anal function evaluated by Williams Scoring and Grading. Results The proportion of achieving primary wound healing was 72.09%(31/43) and average time to wound healing was (47.41±18.39) d. There were 12 patients who could not achieve wound healing three months after the procedure and who received a second procedure, among whom seven achieved wound healing and five had improvement. Overall cure rate was 88.37%(38/43). Patients were followed- up for 6~36 months. No recurrence was found in patients who achieved healing. Forty patients had A grade and three B grade postoperative anal function according to Williams Scoring and Grading. Conclusion Deep catheter drainage plus vacuum aspiration could effectively clear deep infection site in treating high complex fistula and has satisfactory clinical effect.
作者
尹璐
梁宏涛
姚一博
王琛
赵秋枫
Yin Lu;Liang Hongtao;Yao Yibo;Wang Chen;Zhao Qiufeng(Department of Anal and Intestinal Diseases,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;Department of Radiology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China)
出处
《结直肠肛门外科》
2019年第1期13-18,共6页
Journal of Colorectal & Anal Surgery
基金
国家自然科学基金项目(81603618
81603624)
上海市进一步加快中医药事业发展三年行动计划(ZY(2018-2020)-CCCX-1007)
关键词
高位复杂性肛瘘
置管引流
负压吸引
临床效果
high complex fistula
catheter drainage
vacuum aspiration
clinical effectiveness
