摘要
目的:对比改良括约肌间瘘管结扎术与肛瘘切开挂线术的疗效。方法:106例复杂肛瘘患者随机分为A组与B组,各53例,A组采取改良括约肌间瘘管结扎术治疗,B组采取肛瘘切开挂线术治疗,比较两组痊愈率、术后第3 d及第7 d的疼痛VAS评分、住院时间、创口愈合时间、手术前后Wexner肛门失禁评分及随访1年的复发率。结果:A组痊愈率与复发率(96.23%、5.66%)与B组(94.33%、7.55%)相比均无统计学意义(P>0.05);A组术后第3 d与第7 d的VAS评分[(2.82±0.80)分、(1.03±0.31)分]均低于B组[(3.61±0.77)分、(2.26±0.44)分,(P<0.05)];A组住院时间、创口愈合时间[(14.53±2.49)d、(18.62±3.77)d]均短于B组[(18.51±4.66)d、(23.17±5.08)d,(P<0.05)];出院时两组Wexner评分均大幅下降(P<0.05),A组[(0.22±0.07)分]低于B组[(0.30±0.09)分](P<0.05)。结论:较之肛瘘切开挂线术,改良括约肌间瘘管结扎术在减轻术后疼痛、缩短住院时间与创口愈合时间及改善术后肛门功能方面均有较大优势。
Objective To compare the clinical effects of modiiied ligation oi the mterspmnctenc nstma tract and incision-thread-drawing procedure. Methods Total 106 patients with complex anal fistula were se- lected as study subjects and were randomized divided into group A and group B by the random number table method, 53 cases in each group. Group A was treated with modified ligation of the intersphincterie fistula tract while group B was treated with incision-thread-drawing procedure. The cure rate and VAS pain scores 3d and 7d postoperative, hospitalization time, wound healing time, Wexner anal incontinence scores preoperative and postoperative and 1-year recurrence rate were compared between the two groups. Results There were no sig- nificant differences between the cure rate and recurrence rate of group A （96.23%, 5.66% ） and group B （94.33%, 7.55%） （P〉 0.05）. The VAS pain scores 3d and 7d postoperative of group A （2.82±0.80, 1.03±0.31） were lower than group B（3.61±0.77, 2.26±0.44） （P 〈 0.05）. The hospitalization time and wound healing time in group A [（14.53±0.49） d, （18.62±3.77） d] were shorter than those in group B[（18.51±.66） d, （23.17±5.08） d] （P 〈 0.05）. On discharge, Wexner scores of both groups were significantly decreased （P 〈： 0.05）. The Wexner score of group A （0.22±0.07） was lower than group B （0.30±.09） （P 〈 0.05）. Conclusion Compared with in- cision-thread-drawing procedure, modified ligation of the intersphineteric fistula tract has more advantages in re- ducing postoperative pain, shortening the hospitalization time and wound healing time and improving the anal function after surgery.
出处
《中国中西医结合外科杂志》
CAS
2017年第3期243-246,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
复杂肛瘘
改良括约肌间瘘管结扎术
肛瘘切开挂线术
Complex anal fistula
ligation of the intersphincteric fistula tract
incision-thread-drawing pro-cedure for anal fistula
