摘要
目的:观察促愈外用方熏洗对热毒炽盛型肛周脓肿术后创面愈合的临床疗效。方法:采用随机数字表法将90例肛周脓肿患者随机分为对照组和治疗组各45例。两组患者均行脓肿切开引流术(低位肛周脓肿行单纯脓肿切开引流术,高位肛周脓肿行脓肿切开置管引流术)。对照组术后予以高锰酸钾溶液熏洗坐浴,治疗组予以促愈外用方熏洗坐浴。分别检测两组患者术前及术后第3天的白细胞(WBC)、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比率(NLR);比较患者术后第1、7、14天肛门疼痛、创面渗出、肉芽组织评分;在术后第21天评价两组疗效,记录创面愈合时间及不良事件;随访1年,比较两组成瘘率。结果:治疗组的炎症指标(术后第3天)、肛门疼痛(术后第7、14天)、创面渗出(术后第14天)、肉芽组织情况(术后第7、14天)、临床疗效和创面愈合时间均优于对照组(P<0.05)。治疗组成瘘率有低于对照组的趋势,但差异无统计学意义(P>0.05)。结论:促愈外用方熏洗坐浴可有效降低肛周脓肿的炎症指标,减轻术后肛门疼痛,减轻创面渗出,改善肉芽组织,缩短愈合时间,减少术后肛瘘形成,安全有效,值得临床推广。
Objective To observe the clinical effect of fumigating and washing Cuyu Waiyong prescrition on wound healing after operation of perianal abscess with exuberance of heat-toxicity.Methods 90 patients were randomly divided into control group and treatment group,45 in each group.Two groups of patients underwent abscess incision and drainage(low perianal abscess underwent simple incision and drainage,high perianal abscess underwent incision-intubation-drainage).The control group was fumigated with potassium permanganate solution after operation.The treatment group was given Cuyu Waiyong prescription fumigated and washed.WBC,CRP,NLR were measured prior to the operation and on the 3rd day after the operation,respectively.To compare the score of anal pain,wound exudation,granulation tissue and edema of wound margin on the 1st,7th and 14th day after the operation.On the 21th day after the operation,the curative effect of each group was evaluated,and the time of wound healing and adverse events were recorded.Fistula rates of the two groups were compared after 1 year follow-up.Results The treatment group was better than the control group in inflammatory index(the 3rd day after the operation),anal pain(the 7th and 14th day after the operation),wound exudation(the 14th day after the operation),granulation tissue(the 7th and 14th day after the operation),clinical efficacy(the 21st day after the operation)and wound healing time(P<0.05).The fistula rate of the two groups was lower than that of the guidelines(P<0.05).The fistula rate of the treatment group was lower than that of the control group,but the difference was not statistically significant(P>0.05).Conclusion Cuyu Waiyong prescription fumigated and washed effectively reduces the inflammation index of perianal abscess,relieving the postoperative anal pain and the wound exudation.It also improves the granulation tissue and shortens the recovery time.As a result,the treatment has been proven safe and effective,therefore,worth being popularized in clinical application.
作者
薛亭
潘友珍
杨艳黎
周丽波
李研
郑振麟
XUE Ting;PAN You-zhen;YANG Yan-li(Department of Proctology Surgery,Gongli Hospital of Pudong New Area,Shanghai(200135),China)
出处
《中国中西医结合外科杂志》
CAS
2023年第1期11-14,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
上海市卫健委中西医结合专项(ZHYYZXYJHZX-202117)
上海市浦东新区科委项目(PKJ2020-Y74)。
关键词
肛周脓肿
热毒炽盛
促愈外用方
临床疗效
Perianal abscess
exuberance of heat-toxicity
Cuyu Waiyong prescription
clinical efficacy
