摘要
目的 探讨在低位肛瘘治疗时,括约肌间瘘管结扎联合瘘管隧道式切除术的临床疗效。方法 回顾性选取2020年4月至2021年4月在解放军联勤保障部队第904医院门诊肛肠科接诊的76例低位肛瘘患者,根据治疗方法分为对照组(瘘管切开术)和观察组(括约肌间瘘管结扎联合瘘管隧道式切除术),每组38例。对比两组患者的临床效果及创面愈合时间、住院时间情况;同时观察两组患者术后1、3、5 d的视觉模拟评分法(VAS)评分、肛门失禁Wexner评分和术后并发症发生情况。结果 观察组总有效率为97.37%,明显高于对照组(86.84%),差异有统计学意义(P <0.05)。观察组患者的创面愈合时间、住院时间为(22.35±2.14)、(7.12±1.36) d,均明显低于对照组[(26.18±3.17)、(10.23±2.12) d],差异均有统计学意义(P <0.05)。观察组患者的术后1、3、5 d的VAS评分为(1.14±0.64)、(1.26±0.78)、(0.63±0.56)分,均明显低于对照组[(1.68±0.71)、(1.79±0.97)、(1.08±0.79)分],差异均有统计学意义(P <0.05)。观察组患者术后1、3个月的肛门失禁Wexner评分为(2.16±0.78)、(1.63±0.62)月,均明显低于对照组[(3.19±1.58)、(2.57±0.84)月],差异均有统计学意义(P <0.05)。观察组术后并发症总发生率为5.26%,与对照组(10.53%)相比,差异无统计学意义(P> 0.05)。结论 与瘘管切开术相比,采用括约肌间瘘管结扎联合瘘管隧道式切除术治疗低位肛瘘临床疗效明显提高,能缩短患者术后肛门疼痛时间及住院时间,缓解患者疼痛和肛门失禁程度,值得临床推广应用。
Objective To explore the clinical effect of intersphincteric fistula ligation combined with tunnel resection of fistula in the treatment of low anal fistula.Methods A total of 76 patients with low anal fistula in the Department of Outpatient Anorectal,PLA Joint Logistic Support Force 904th Hospital from April 2020 to April 2021 were retrospectively selected.According to the treatment method,they were divided into control group( fistula incision) and observation group( Intersphincteric fistula ligation combined with tunnel resection of fistula),38 cases in each group.The clinical effects,wound healing time and hospital stay of the two groups of patients were compared;at the same time,the visual analogue scale( VAS) scores,Wexner scores of anal incontinence and the occurrence of postoperative complications of the two groups were observed at 1 day after surgery,3 days after surgery,and 5 days after surgery.Results The total effective rate of the observation group was 97.37%,which was significantly higher than that of the control group( 86.84%),and the difference was statistically significant( P < 0.05).The wound healing time and hospital stay of the observation group were( 22.35 ± 2.14) and( 7.12 ± 1.36) d,which were significantly lower than those in the control group [( 26.18 ± 3.17),( 10.23 ± 2.12) d],and the differences were significant( P < 0.05).The VAS scores of patients in the observation group were( 1.14 ± 0.64),( 1.26 ± 0.78) and( 0.63 ± 0.56),which were significantly lower than those in the control group at 1,3,and 5 days after surgery[( 1.68 ± 0.71),( 1.79 ± 0.97),( 1.08 ± 0.79) points],and the differences were statistically significant( P < 0.05).The Wexner scores of anal incontinence in the observation group at 1 month and 3 months after surgery were( 2.16 ± 0.78),( 1.63 ± 0.62)months,which were significantly lower than those in the control group [( 3.19 ± 1.58),( 2.57 ± 0.84) months],and the differences were significant( P < 0.05).The total incidence of postoperative complications in the
作者
张超杰
张卫平
贺祥坤
ZHANG Chao-jie;ZHANG Wei-ping;HE Xiang-kun(Department of Anorectal Surgery,PLA Joint Logistic Support Force 904th Hospital,Wuxi Jiangsu 214044,China)
出处
《临床和实验医学杂志》
2022年第8期860-863,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省科学技术委员会辅助支持项目(编号:BK20170206)。
关键词
低位肛瘘
瘘管隧道式切除术
括约肌间瘘管结扎术
临床疗效
Low anal fistula
Tunnel resection of fistula
Intersphincter fistula ligation
Clinical efficacy
