摘要
目的 探讨改良切口引流联合挂线术治疗高位复杂性肛瘘临床疗效和安全性,为高位复杂性肛瘘的治疗提供更可靠的治疗方法.方法 选取本院2010年12月-2012年12月收治的80例高位复杂性肛瘘患者,随机分为两组,每组40例.观察组采用改良切口引流联合挂线术,对照组采用切开旷置引流术.观察两组患者的手术效果、并发症发生率;术后随访3~6个月,分别观察患者复发及并发症发生情况;采用Wexner评分对患者术后及3个月后分别进行评分.结果 观察组痊愈率为92.5%,对照组为62.5%,两组差异显著（P＜0.05）.观察组术后肛门水肿发生率为5.0%、继发出血为2.5%、感染发生率为0,均低于对照组（P＜0.05）.随访3个月,观察组复发率为0,对照组为12.5%,两组差异显著（P＜0.05）.两组Wexner评分在3个月后比较,观察组为0.8±0.6,明显低于对照组的1.7±0.7（P＜0.05）.结论 改良切口引流联合挂线术治疗高位复杂性肛瘘有效处理了感染组织,引流有效,避免了广泛切开,保护了肛门括约肌,治愈率高,且术中、术后并发症少,复发率低,值得临床推广应用.
Objective To discuss the curative effects of modified incisional drainage combined with seton on complex high positional anal fistula and its safety, and to provide more rehable treatment method for the disease. Methods Eighty patients with complex high positional anal fistula and hospitalized between December 2010 and December 2012 were selected and randomly divided into two groups with 40 ones in each group. Observation group received the modified incisional drainage combined with seton, while control group received incisional exclusion drainage. Observation was made in the surgical effects and the incidence of complications in both groups. Postoperative follow-up was made for 3-6 months. Recurrence and complications in both groups were observed. The patients were evaluated by Wexner scoring at the post-operation and 3 months after the operation. Results The cure rates of the observation and control groups were 92.5% and 62.5%, respectively,and the differences were significant （P 〈 0.05 ）. The incidence of anal edema, secondary hemorrhage, and infection was 5.0% ,2.5%, and 0 in the observation group, respectively, which were all less than that in the control group （P 〈 0.05 ）. During the three-month follow-up, the recurrence rates of the observation and the control groups were 0 and 12.5%, respectively, and the differences were significant （P 〈 0.05 ）. Three months later, the Wexner score of the observation group were 0.8 ± 0.6 which were significantly lower than that of the control group （ 1.7 ± 0.7, P 〈 0.05 ）. Conclusion The treatment of complex high positional anal fistula by modified incisional drainage combined with seton is effective. This method can deal with the infected tissues with effective drainage, avoid extensive incision, and protect the anal sphincter. The cure rate is high, and peripostoperative complications are much fewer. Recurrence rate is also low. It is worthy of chnical application.
出处
《西南国防医药》
CAS
2014年第2期163-165,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
肛瘘
挂线术
引流
疗效
anal fistula
seton
drainage
curative effect
