摘要
目的观察拖线(置管)垫棉疗法治疗复杂性肛瘘的临床疗效。方法选择2017年1月—2020年12月在上海市金山区中西医结合医院肛肠科初次住院手术的复杂性肛瘘患者100例,随机分为2组各50例。治疗组低位复杂性肛瘘29例采用拖线垫棉疗法进行治疗,高位复杂性肛瘘21例采用拖线置管垫棉疗法进行治疗。对照组低位复杂性肛瘘30例采用切开术进行治疗,高位复杂性肛瘘20例采用切开挂线术进行治疗。比较2组治愈率、创面愈合时间、肛门疼痛和肛门渗液的差异;术后随访6个月,比较2组复发率、Wexner评分和肛门功能评估自测情况。结果2组治愈率、术后6个月随访复发率比较差异均无统计学意义(P均>0.05);治疗组创面愈合时间为(27.1±2.2)d,对照组为(30.1±2.4)d,组间比较差异有统计学意义(P<0.05);治疗组术后第3天及第7天肛门疼痛评分与术后第7天、第11天肛门渗液积分均明显低于对照组(P均<0.05);治疗组手术前后Wexner评分和肛门功能自测评分比较差异均无统计学意义(P均>0.05),而对照组手术前后Wexner评分和肛门功能自测评分比较差异均有统计学意义(P均<0.05);术后6个月治疗组Wexner评分优于对照组(P<0.05)。结论拖线(置管)垫棉疗法治疗复杂性肛瘘相较于切开术(切开挂线术)对肛门功能保护更好,并发症较少,创面愈合更快。
Objective It is to observe the clinical effect of suture dragging(catheter drainage)plus pad compression therapy in the treatment of complex anal fistula.Methods A total of 100 patients with complex anal fistula who firstly underwent initial inpatient operation in the Anorectal Department of Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2020 were selected and randomly divided into two groups,with 50 cases in each group.29 cases of low complex anal fistula in the treatment group were treated with suture dragging plus pad compression therapy,21 cases of high complex anal fistula were treated with suture dragging(catheter drainage)plus pad compression therapy.30 cases of low complex anal fistula in the control group,were treated with incision surgery,20 cases of high complex anal fistula were treated with incision surgery and thread-ligating.The differences in cure rate,wound healing time,anal pain and anal exudate were compared between the two groups;after 6-month follow-up,the recurrence rate,Wexner score and self-assessment of anal function were compared between the two groups.Results There was no significant difference in the cure rate and recurrence rate at 6-month follow-up between the two groups(P>0.05).The wound healing time in the treatment group was(27.14±2.21)d,while that in the control group was(30.06±2.39)d,and the difference was statistically significant(P<0.05),the difference between the groups was statistically significant(P<0.05).The anal pain score on the 3rd and 7th days after operation and the anal exudate score on the 7th and 11th days after operation in the treatment group were significantly lower than those in the control group(all P<0.05).There was no significant difference in the Wexner score and anal function self-assessment score before and after the operation in the treatment group(P>0.05),while there were statistical differences in the Wexner score and anal function self-assessment score before and after the operation in
作者
彭军良
吴仕旺
杨坚
姚向阳
陆金根
张丹凤
张华
朱宝国
PENG Junliang;WU Shiwang;YANG Jian;YAO Xiangyang;LU Jingen;ZHANG Danfeng;ZHANG Hua;ZHU Baoguo(Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201501,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《现代中西医结合杂志》
CAS
2022年第13期1769-1774,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
上海市金山区卫生健康委员会第六周期医学重点专科建设项目(JSZK2019A02)
国家中医药管理局全国名老中医药专家传承工作室建设项目[(2016)167]
上海市卫生健康委员会中医药(中医专科)专门人才计划项目(ZY3-RCPY-3-1014)
2018年度上海市金山区专家工作站(卫生领域)(jszjz2018020Y)。
关键词
拖线垫棉疗法
拖线置管垫棉疗法
切开术
切开挂线术
复杂性肛瘘
suture dragging plus pad compression therapy
suture dragging(catheter drainage)plus pad compression therapy
incision surgery
incision and thread-ligating therapy
complex anal fistula
