摘要
目的:观察基于挂线机理下括约肌保留术治疗坐骨直肠间隙脓肿的疗效及其并发症。方法:采用前瞻性随机对照的研究方法,将100例坐骨直肠间隙脓肿患者随机分为治疗组和对照组,每组50例。对照组采用一次性切开挂线术,治疗组采用切割挂线与松弛挂线相结合的括约肌保留术,比较两组临床疗效、切口愈合时间、肛门功能、切口疼痛、手术时间、术后住院时间等指标。结果:治疗组痊愈44例(88.00%),对照组痊愈48例(96.00%),两组疗效差异无统计学意义(χ^(2)=-1.47,P>0.05)。治疗组切口愈合时间为[23.00(20.00,26.00)]d,短于对照组的[27.00(24.00,30.00)]d;治疗组术后6月肛门失禁Wexner评分为[1.00(0.00,1.00)],低于对照组的[1.00(0.00,3.00)];治疗组术后切口疼痛NRS评分第1、3、7天分别为[6.00(5.75,7.00)]、[3.00(3.00,4.25)]、[1.00(1.00,2.00)],均低于对照组的[8.00(7.00,8.00)]、[5.00(5.00,5.25)]、[2.00(2.00,3.00)];治疗组手术时间为[35.00(25.00,40.00)]min,长于对照组的[21.00(15.00,30.00)]min,差异有统计学意义(P<0.05)。治疗组术后住院时间为[6.00(5.00,7.00)]d,对照组为[6.00(6.00,7.00)]d,差别无统计学意义(P>0.05)。结论:基于挂线机理下的括约肌保留术能有效保护肛门功能,治疗坐骨直肠间隙脓肿疗效确切,术后疼痛轻,愈合时间短。
Objective To observe the curative efficacy and complications of sphincter preservation surgery based on thread-drawing therapy of TCM for the treatment of ischiorectal fossa abscess.Methods A prospective randomized controlled study was conducted,in which 100 patients with ischiorectal fossa abscess were randomly divided into a treatment group and a control group,with 50 cases in each group.The treatment group underwent sphincter preservation surgery based on thread-drawing therapy of TCM,while the control group underwent thread hanging technique of TCM.The curative efficacy,incision healing time,anal function,incision pain,surgical time,and postoperative hospital stay were compared between the two groups.Results 44 cases were cured in the treatment group,while 48 cases were cured in the control group.There were no significant statistical differences in the cure rate between the two groups(P>0.05).The incision healing time in the treatment group[23.00(20.00,26.00)]d was shorter than the control group[27.00(24.00,30.00)]d.The Wexner incontinence score in the treatment group[1.00(0.00,1.00)]was lower than the control group[1.00(0.00,3.00)]at 6 months after surgery.The NRS pain scores of postoperative incision in the treatment group[6.00(5.75,7.00)],[3.00(3.00,4.25)],and[1.00(1.00,2.00)]on the 1st,3rd,and 7th day were all lower than the control group[8.00(7.00,8.00)],[5.00(5.00,5.25)],and[2.00(2.00,3.00)]respectively.The surgical time in the treatment group[35.00(25.00,40.00)]min was longer than the control group[21.00(15.00,30.00)]min.There were significant statistical differences(P<0.05).The postoperative hospital stay time was[6.00(5.00,7.00)]days in the treatment group,while the control group was[6.00(6.00,7.00)]days.There were no significant statistical differences between the two groups(>0.05).Conclusion Sphincter preservation surgery based on thread-drawing therapy of TCM could effectively protect the anal function,provide definite treatment for ischiorectal fossa abscess,and result in less postoperative pain
作者
陈富军
刘昌萍
原相军
李杉
程英杰
李成书
贺平
CHEN Fu-jun;LIU Chang-ping;YUAN Xiang-jun(Department of Coloproctology,West China Hospital,Longquan Hospital,Chengdu 610100,China)
出处
《中国中西医结合外科杂志》
CAS
2023年第6期730-735,共6页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
四川省中医药管理局2021年度中医药科研专项课题(2021MS314)。
关键词
坐骨直肠间隙脓肿
中医挂线疗法
括约肌保留术
Ischiorectal fossa abscess
thread-drawing therapy of TCM
sphincter preservation surgery
