摘要
目的观察TROPIS联合改良Parks虚挂线术治疗高位复杂性肛瘘的临床疗效。方法回顾性分析2019年5月至2019年10月在广西中医药大学第一附属医院住院治疗的70例高位复杂性肛瘘患者的临床资料,根据手术方式的不同,分为TROPIS组(采用TROPIS联合改良Parks虚挂线术,n=35)与切挂组(采用切开挂线术,n=35)。观察记录两组手术时间、术中出血量、创口疼痛评分(术后第1、3、7天)、创面出血评分(术后第1、3、7天)、创口完全愈合时间、瘢痕面积、肛门功能(术后1、3个月)、临床疗效及复发情况。结果两组患者均顺利完成手术。TROPIS组的手术时间及术后创口完全愈合时间短于切挂组,术中出血量少于切挂组,瘢痕面积小于切挂组,术后不同时点(第1、3、7天)的创口疼痛评分、创面出血评分及术后1、3个月肛门Wexner评分低于切挂组,差异均有统计学意义(均P<0.05);两组治疗后1个月总有效率、术后半年复发率比较差异均无统计学意义(均P>0.05)。结论与传统切挂术相比,TROPIS联合改良Parks虚挂线术治疗高位复杂性肛瘘能减少术中出血、缩短手术时间、减轻术后肛门疼痛、减少创面出血、缩短创口愈合时间、减少瘢痕面积,在保证疗效的情况下能更好地保护肛门功能。
Objectives To investigate the clinical effectiveness of transanal opening of intersphincteric space(TROPIS)combined with modified Parks procedure for high complex anal fistula.Methods This was a retrospective analysis of 70 patients with high complex anal fistula treated in the First Affiliated Hospital of Guangxi University of Chinese Medicine,between May 2019 and October 2019.Patients were divided into TROPIS group(receiving TROPIS combined with modified Parks procedure,n=35)and seton group(receiving regular seton,n=35).Duration of surgery,intraoperative blood loss,wound pain and wound bleeding at 1,3,and 7 days after surgery,wound healing time,the scar area,anal function at 1 and 3 months after surgery,overall effectiveness,and recurrence were recorded.Results All surgeries were uneventful.Compared with the seton group,the TROPIS group had significantly shorter duration of surgery,shorter wound healing time,fewer intraoperative blood loss,smaller scar area,lower pain visual analogue scales and wound bleeding scores at 1,3,and 7 days after surgery,and lower Wexner scores at 1 and 3 months after surgery(P<0.05).Overall effectiveness at 1 month and recurrence at 6 months after surgery did not differ between the two groups(P>0.05).Conclusion Compared with regular seton,TROPIS combined with modified Parks procedure can reduce intraoperative bleeding,shorten the duration of surgery,alleviate postoperative anal pain,reduce wound bleeding,shorten wound healing time,and reduce scar area.It can also protect anal function while ensuring good effectiveness.
作者
胡启炳
刘文
谢丹丹
庞黎明
Hu Qibing;Liu Wen;Xie Dandan;Pang Liming(The First Clinical Faculty of Guangxi University of Chinese Medicine,Nanning 530001,Guangxi Zhuang Autonomous Region,China;Department of Gastrointestinal and Anal Surgery,The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nan-ning 530023,Guangxi Zhuang Autonomous Region,China)
出处
《结直肠肛门外科》
2021年第1期49-52,共4页
Journal of Colorectal & Anal Surgery
关键词
高位复杂性肛瘘
TROPIS联合改良Parks虚挂线术
临床疗效
high complex anal fistula
transanal opening of intersphincteric space combined with modified Parks procedure
clinical effectiveness
作者简介
通信作者:庞黎明,E-mail:ldgido@163.com。
