摘要
目的观察部分瘘管切开、肛瘘栓填塞术联合丹红注射液治疗高位经括约肌肛瘘的疗效及对肛门功能和直肠肛门压力的影响。方法将94例高位经括约肌肛瘘患者随机分为观察组47例及对照组47例,2组均行部分瘘管切开+肛瘘栓填塞术治疗,观察组于术后第1天开始给予丹红注射液治疗,应用至术后14 d。观察2组术后1,3,7,14d的肛门疼痛、渗出和肿胀情况,记录2组的临床结局;并观察2组术前、术后14 d的肛门功能、肛管直肠压力。结果观察组术后3,7,14 d的肛门疼痛、渗出和肿胀情况评分均明显低于对照组(P均<0.05);观察组创面愈合时间、脓腐脱落时间、便血时间、创面瘢痕面积、住院费用、住院时间均明显低于对照组(P均<0.05);2组术后7,14 d Wexner评分(干便、稀便、气体、需要衬垫、生活方式改变及总分)均显著高于术前(P均<0.05),距肛门20,30 mm处的肛管直肠压力(静息压、收缩压与压力阈值)均显著低于术前(P均<0.05),且观察组术后7,14 d上述指标改善情况均明显优于对照组(P均<0.05)。结论在部分瘘管切开+肛瘘栓填塞术治疗高位经括约肌肛瘘基础上,采用丹红注射液治疗能够减轻术后疼痛,促进术后创面修复,缩短治愈时间,进而保护肛门功能及维持直肠肛门压力。
Objective It is to observe the effects of partial fistula incision,anal fistula plugging combined with Danhong injection in the treatment of upper sphincter anal fistula and its effect on anal function and rectal anal pressure.Methods Ninety-four patients with upper sphincter anal fistula were randomly divided into observation group(n=47)and control group(n=47).Both groups were treated with partial fistula incision plus anal fistula embolization.The observation group was treated with Danhong injection from the first postoperative day to 14d after surgery.Anal pain,exudation and swelling of the two groups were observed on the 1st,3rd,7th and 14th day after operation.The clinical outcomes of the two groups were recorded.Anal function and anal canal pressure were observed before and 14 days after operation.Results The scores of anorectal pain,exudation and swelling on the 3rd,7th and 14th postoperative days in the observation group were lower than those in the control group(all P<0.05).The wound healing time,detached abscess time,blood stool time,scar area,hospitalization expenses and stays were significantly shorter or less than those in the control group(P<0.05).The Wexner scores(dry stools,loose stools,gas,linings needed,lifestyle changes and total scores)at 7d and 14d after operation were significantly higher while the preoperative anorectal pressure(resting pressure,systolic pressure and pressure threshold)at 20 and 30 mm from the anus was lower than those before treatment in both groups(P<0.05),and the improvements of the above indexes in the observation group at 7 and 14 days after operation were better than that in the control group(P<0.05).Conclusion Based on partial fistulotomy plus anal fistula embolization for upper sphincter anal fistula,the use of Danhong injection can reduce postoperative pain and promote postoperative wound repair,shorten the healing time,thus to protect the anal function and maintain rectal anal pressure.
作者
杨小林
刘艳
YANG Xiaolin;LIU Yan(The People’s Hospital of Kaizhou District,Chongqing,Chongqing 405400,China)
出处
《现代中西医结合杂志》
CAS
2018年第10期1062-1066,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
瘘管切开
肛瘘栓填塞术
高位经括约肌肛瘘
丹红注射液
肛门功能
fistula incision
anal fistula embolization
high sphincter anal fistula
Danhong injection
anal function
作者简介
杨小林，男，医师，主要从事肛肠外科临床工作。;［通信作者］刘艳，E-mail：380557387@qq.com
