摘要
目的复杂肛瘘临床常以手术方式治疗,切开挂线术为常用术式,但以该术式治疗术后并发症较多。微创技术近年来在临床运用日益成熟,本研究探讨复杂肛瘘患者使用常规切开挂线术与微创手术治疗对其疼痛程度和并发症的影响,旨在为手术治疗复杂肛瘘提供参考依据。方法选取2017-01-01-2019-02-15南阳市第二人民医院肛肠外科收治的复杂肛瘘患者为研究对象,根据组间性别、年龄、病程、病灶部位均衡的原则选择对照组与观察组,每组37例。对照组实施常规切开挂线术,观察组予以微创手术治疗。比较两组手术临床指标和疼痛程度并发症情况。结果观察组和对照组术中出血量分别为(25.03±8.97)和(36.24±9.14)mL,t=5.325,P<0.001;手术时间分别为(44.58±8.71)和(57.39±9.35)min,t=6.098,P<0.001;住院时间分别为(4.08±1.42)和(7.39±2.14)d,t=7.840,P<0.001;观察组和对照组术后3dVAS评分分别为(4.91±1.97)和(8.07±1.11)分,t=8.501,P<0.001;术后7dVAS评分分别为(3.29±1.25)和(6.31±2.88)分,t=5.851,P<0.001;术后14dVAS评分分别为(1.39±0.85)和(2.31±1.24)分,t=3.722,P<0.001;差异均有统计学意义。观察组并发症发生率为8.11%,低于对照组的29.73%,χ2=5.638,P=0.018。结论复杂性肛瘘患者采用微创手术治疗,可有效提升手术效果,缩短手术时间与住院时间,缓解术后疼痛,降低并发症的发生率。
OBJECTIVE Surgical treatment is often used in the treatment of complex anal fistula,conventional incision and thread-drawing operation is the common method,but there are many postoperative complications.Minimally invasive technology has become more and more mature in clinical application in recent years.This study aims to analyze the effect of conventional incision and thread-drawing operation versus minimally invasive surgery on pain degree and complications in patients with complex anal fistula,and to provide reference for surgical treatment of complex anal fistula.METHODS The patients with complex anal fistula admitted to the anorectal surgery of Second People’s Hospital of Nanyang from January 1,2017 to February 15,2019 were selected as subjects.All selected cases were divided into control group and observation group according to the gender,age,course of disease and lesion site,with 37 cases in each group.Control group underwent conventional incision and thread-drawing operation,while observation group was given minimally invasive surgery.The clinical surgical indexes,pain degree,complications were compared between two groups.RESULTS The intraoperative blood loss of the observation group and the control group were(25.03±8.97)ml and(36.24±9.14)ml,t=5.325,P<0.001.The operation time was(44.58±8.71)min and(57.39±9.35)min,t=6.098,P<0.001.The hospitalization time was(4.08±1.42)d and(7.39±2.14)d,t=7.840,P<0.001.The VAS scores of the observation group and the control group were(4.91±1.97)and(8.07±1.11),t=8.501,P<0.001,respectively.The VAS scores at the 7 th day after surgery were(3.29±1.25)and(6.31±2.88),respectively,t=5.851,P<0.001.The VAS scores at 14 days postoperatively were(1.39±0.85)and(2.31±1.24),t=3.722,P<0.001.The difference was statistically significant,both P<0.05.The incidence of complications in the observation group was8.11%,which was lower than 29.73%in the control group,χ2=5.638,P=0.018.CONCLUSIONS Patients withcomplicated anal fistula should be treated with minimally invasive surgery,which can effectively improve the operation,reduce the operation time and hospital stay,relieve postoperative pain and reduce the incidence of complications.
作者
李谦
叶道冰
LI Qian;YE Dao-bing(Department of Anus and Intestine Surgery,Second People's Hospital of Nanyang,Nanyang 473000,P.R.China)
出处
《社区医学杂志》
2019年第20期1285-1287,1291,共4页
Journal Of Community Medicine
关键词
复杂肛瘘
常规切开挂线术
微创手术
疼痛程度
complex anal fistula
conventional incision and thread-drawing operation
minimally invasive surgery
pain degree
作者简介
通讯作者:李谦,男,河南南阳人,主治医师,主要从事肛肠外科的临床研究工作。Tel:86-377-61609208,E-mail:liqian12022@126.com
