摘要
目的:观察低位切开高位虚挂线术治疗高位肛瘘的疗效。方法:选取94例高位单纯性肛瘘患者,采用随机数字表法分为治疗组和对照组,治疗组行低位切开高位虚挂线术治疗,对照组接受低位切开高位常规挂线术治疗。进行3个月的随访,分别于出院时、治疗后1个月和3个月测定肛门直肠压力,包括:直肠静息压(RRP)、肛管静息压(ARP)、肛管最长收缩时间(ALCT)、肛管最大收缩压(AMCP);记录治愈时间(d)、治愈率及复发情况。结果:出院时,治疗组RRP、ARP、ALCT和AMCP与对照组相比差异无统计学意义(P>0.05),治疗组ARP和AMCP显著高于对照组(P<0.05)。治疗后1个月,治疗组RRP、ARP、ALCT和AMCP与对照组RRP、ARP、ALCT和AMCP比较差异无统计学意义(P>0.05),治疗组ARP和AMCP显著高于对照组(P<0.05)。治疗后3个月后,治疗组RRP、ARP、ALCT和AMCP分别为(3.53±0.72)kPa、(19.87±3.82)kPa、(35.16±5.12)min和(25.36±5.93)kPa,对照组RRP、ARP、ALCT和AMCP分别为(3.23±0.68)kPa、(17.24±3.61)kPa、(36.25±4.83)min和(22.65±5.12)kPa,治疗组RRP、ARP和AMCP高于对照组(P<0.05),ALCT显著低于对照组(P<0.05)。治疗组与对照组总有效率无显著性差异(91.49%vs 89.36%,P=0.537),且治疗组平均治愈时间短于对照组[(28.43±2.78)d vs(33.62±3.27)d,P=0.003];对照组复发1例。结论:低位切开高位虚挂线术能显著保护高位肛瘘患者的肛门功能。
Objective To study the clinical efficacy of low-cut high-level virtual hanging in the treatment of high anal fistula. Methods Ninety-four cases with high anal fistula were divided into treatment group and control group according to random number table method. Patients in the treatment group were treated with lowcut high-level virtual hanging therapy, while patients in the control group were treated with common low-cut high-level hanging therapy. During the 3 months following-up, the anus and rectal pressure including rectal rest pressure（RRP）, anal rest pressure（ARP）, anal longest construction time（ALCT） and anal maximal construction pressure（AMCP） at the time of discharging, 1 month and 3 months after treatment were recorded. The cure time, cure rate and recurrence rate of the patients were also recorded. Results At the time of discharging, there was no significant difference in the levels of RRP, ARP, ALCT and AMCP among the two groups（P〈0.05）. The levels of ARP and AMCP in the treatment group were significantly higher than those in the control group（P〈0.05）. One month after treatment, the levels of RRP, ARP, ALCT and AMCP were [（3.26±0.58） kPa], [（17.63±4.127） kPa], [（37.02±5.35） min], [（23.86±4.89） kPa] in the treatment group, and [（3.07±0.52） kPa], [（16.93±4.11） kPa], [（36.47±5.01） kPa], [（21.92±4.72） kPa] in the control group, respectively. There was no significant difference in RRP and ALCT between the two groups（P〈0.05） and the levels of ARP and AMCP in the treatment group were significantly higher than those in the control group（P〈0.05）. Three months after the treatment, the levels of RRP, ARP, ALCT and AMCP were [（3.53±0.72） kPa], [（19.87±3.82） kPa], [（35.16±5.12） min], [（25.36±5.93） kPa] in the treatment group, and [（3.23±0.68） kPa], [（17.24±3.61） kPa], [（36.25±4.83） min], [（22.65±5.12） kPa] in the control group, respectively. The levels of RRP, ARP and AMCP in the treatment group were significantly higher than those in the control group（P〈0.05） and ALCT was significantly lower than that in the control group（P〈0.05）. There was no significant difference in the total effective rate between the two groups（91.49% vs 89.36%, χ^2=0.382, P =0.537）, and the average cure time of the treatment group was shorter than that of the control group [（28.43±2.78） d vs（33.62±3.27） d, P=0.03]. There was one case of recurrence in control group. Conclusion Low-cut high-level virtual hanging therapy can significantly protect the anus function of patients with high anal fistula.
作者
郭佑建
GUO You-jian(Department of General Surgery,Sichuan General Petroleum Hospital,Chengdu（610213）,China)
出处
《中国中西医结合外科杂志》
CAS
2018年第3期271-275,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
低位切开高位虚挂线术
高位肛瘘
临床疗效
Low-cut high-level virtual hanging
high anal fstula
clinical effcacy
作者简介
通信作者：郭佑建,E-mail：gggyyija@126.com
