摘要
目的:比较六神丸药线挂线与橡皮筋挂线疗法对高位单纯性肛瘘患者临床疗效、肛管直肠压力及肛门括约肌功能的影响。方法:选取2020年1月—2021年2月于唐山市中医医院肛肠科住院的78例高位单纯性肛瘘患者,随机均分为对照组和观察组各39例。两组患者均接受低位瘘道切开高位挂线手术,而对照组采用传统橡皮筋挂线治疗,观察组采用六神丸药线挂线治疗。比较两组患者术后主要症状(疼痛、肿胀、渗液)、创面愈合时间,并评定临床疗效;比较两组患者治疗前后肛管直肠压力、肛门括约肌功能变化,并评价两组患者不良反应情况。结果:观察组术后创面愈合时间为(19.63±2.43)d,明显低于对照组的(25.49±3.09)d,差异有统计学意义(P<0.05);观察组术后第14天疼痛、肿胀、渗液积分为(1.54±0.51)分、(0.92±0.28)分、(0.89±0.31)分,分别低于对照组的(3.22±0.67)分、(1.43±0.50)分、(1.38±0.49)分,差异有统计学意义(P<0.05)。观察组术后第14天肛管直肠收缩压为(21.89±3.44)kPa,明显高于对照组的(18.08±2.63)kPa,差异有统计学意义(P<0.05)。观察组术后第14天Wexner肛门失禁评分为(8.08±0.83)分,明显低于对照组的(10.08±1.26),差异有统计学意义(P<0.05)。观察组的不良反应发生率为5%(2/37),明显低于对照组的22%(8/37),差异有统计学意义(P<0.05)。结论:六神丸药线挂线治疗高位单纯性肛瘘具有减轻术后疼痛、肿胀、渗液等优点,同时可缩短创面愈合时间。六神丸药线挂线疗法不良反应发生率少,同时可以明显改善高位单纯性肛瘘患者的肛管直肠压力、肛门括约肌功能。
Objective To compare the effects of Liushen Pill thread hanging therapy and rubber band thread hanging therapy on the clinical efficacy,anorectal pressure and anal sphincter function of patients with high simple anal fistula.Methods 78 patients with high simple anal fistula were randomly divided into control group and observation group.Both groups received low fistula incision and high thread hanging operation,while the control group was treated with traditional rubber band thread hanging treatment,and the observation group was treated with Liushen Pill thread hanging treatment.The main symptoms(pain,swelling,exudation)and wound healing time of the two groups were compared,and the clinical curative effect was evaluated.The anorectal pressure and anal sphincter function of the two groups were compared before and after treatment,and the adverse reactions of the two groups were evaluated.Results The postoperative wound healing time in the observation group was(19.63±2.43)d,which was significantly lower than that in the control group(25.49±3.09)d(P<0.05).The scores of pain,swelling and exudation 14 days after operation in the observation group were(1.54±0.51),(0.92±0.28)and(0.89±0.31)respectively,which were lower than those in the control group(3.22±0.67),(1.43±0.50)and(1.38±0.49)(P<0.05).The anorectal systolic pressure in the observation group was(21.89±3.44)kPa 14 days after operation,which was significantly higher than that in the control group(18.08±2.63)kPa(P<0.05).The postoperative Wexner anal incontinence score of the observation group was(8.08±0.83),which was significantly lower than that of the control group(10.08±1.26)(P<0.05).The incidence of adverse reactions in the observation group was 5.5%(2/37),which was significantly lower than 22%(8/37)in the control group(P<0.05).Conclusion Liushen Pill thread hanging in the treatment of high simple anal fistula has the advantages of reducing postoperative pain,swelling and exudation,and can shorten the wound healing time.Liushen Pill thread hanging therapy has less adverse reactions,and can significantly improve the anorectal pressure and anal sphincter function in patients with high simple anal fistula.
作者
孙英杰
刘越军
刘振生
王新策
高建垠
SUN Ying-jie;LIU Yue-jun;LIU Zhen-sheng(Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China)
出处
《中国中西医结合外科杂志》
CAS
2022年第2期218-222,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
河北省中医药管理局中医药类科研计划课题(2019222)。
关键词
高位单纯性肛瘘
药线挂线
六神丸
橡皮筋挂线
肛管直肠压力
肛门括约肌功能
high simple anal fistula
drug thread drawing
Liushen Pill
rubber band thread drawing
anorectal pressure
anal sphincter function
作者简介
通信作者:孙英杰,E-mail:maqiuyan78@126.com。
