摘要
目的比较高位虚挂线引流与三间隙引流治疗高位肛周脓肿的效果。方法抽取2016年1月至2020年12月于朔州市第三人民医院行高位肛周脓肿切开引流的91例患者,按随机数字表法分为高位虚挂线引流组(46例)和三间隙引流组(45例)。高位虚挂线引流组术中给予高位虚挂线引流,三间隙引流组给予切开三间隙引流。比较两组相关临床指标(手术、住院及创面愈合时间)、肛门功能(肛管静息压、最大收缩压和Wexner评分)、疼痛因子水平[5-羟色胺(5-HT)、P物质(SP)、去甲肾上腺素(NE)]、炎性因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]及并发症发生率。结果高位虚挂线引流组手术时间、住院时间及创面愈合时间均短于三间隙引流组(P均<0.05)。术后1个月,高位虚挂线引流组肛管静息压和最大收缩压高于三间隙引流组,Wexner评分低于三间隙引流组(P<0.05)。术后3 d,高位虚挂线引流组血清5-HT、SP、NE水平均低于三间隙引流组(P均<0.05),且TNF-α、IL-1β、IL-6水平亦低于三间隙引流组(P<0.05)。高位虚挂线引流组并发症发生率(4.35%,2/46)低于三间隙引流组(17.78%,8/45),P<0.05。结论与三间隙引流相比,高位虚挂线引流对高位肛周脓肿切开引流患者肛门功能的损伤小,且可有效减轻疼痛、降低炎性因子水平,减少并发症。
Objective To compare the therapeutic effect of high virtual thread-drawing drainage and three-gap drainage on high perianal abscess.Methods Ninety-one patients treated by incision and drainage of high perianal abscess in Shuozhou Third People’s Hospital from January 2016 to December 2020 were selected,and they were divided into high virtual thread-drawing drainage group(46 cases)and three-gap drainage group(45 cases)by random number table method.The high virtual thread-drawing drainage group was given high virtual thread-drawing drainage during operation,and the three-gap drainage group was given incision and three-gap drainage.The clinical indexes(operation time,hospital stay,wound healing time),anal function assessed by anal canal rest pressure,maximum systolic pressure of anal canal and Wexner score,levels of pain factors including 5-hydroxytryptamine(5-HT),substance P(SP)and norepinephrine(NE),levels of inflammatory factors,including tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-6(IL-6),and incidence of complications were compared between the two groups.Results The operation time,hospital stay and wound healing time in the high virtual thread-drawing drainage group were shorter than those in the three-gap drainage group(all P<0.05).One month after surgery,anal canal rest pressure and maximum systolic pressure of anal canal in the high virtual thread-drawing drainage group were higher than those in the three-gap drainage group,while Wexner score was lower than that in the three-gap drainage group(P<0.05).Three days after surgery,levels of serum 5-HT,SP and NE in the high virtual thread-drawing drainage group were lower than those in the three-gap drainage group(all P<0.05),and the serum levels of TNF-α,IL-1βand IL-6 in the high virtual thread-drawing drainage group were lower than those in the three-gap drainage group(P<0.05).The complication rate of the high virtual thread-drawing drainage group(4.35%,2/46)was lower than that in the three-gap drainage group(17.78%,8/45),P<0.05.Conclusions Compared with three-gap drainage,high virtual thread-drawing drainage has little damage to the anal function of patients undergoing incision and drainage of high perianal abscess,and can effectively inhibit pain,reduce the level of inflammatory factors,and reduce the complications.
作者
高敏
赵武波
Gao Min;Zhao Wubo(Department of General Surgery,Shuozhou Third People's Hospital,Shuozhou 036002,China)
出处
《中国实用医刊》
2023年第8期11-14,共4页
Chinese Journal of Practical Medicine
关键词
肛周脓肿
高位虚挂线引流
三间隙引流
Perianal abscess
High virtual thread-drawing drainage
Three-gap drainage
