低位切开结合引流挂线治疗高位肛瘘和高位脓肿疗效观察

目的观察低位切开结合引流挂线治疗高位肛瘘和高位脓肿的效果。方法采用随机对照、大样本量、前瞻性研究、多中心试验的方法，将193例高位肛瘘及高住脓肿患者随机分为引流挂线组和切割挂线组，在正确处理内口的前提下，分别采用内口上方引流挂线法（虚挂线）和内口上方切割挂线法（实挂线）治疗，观察2组疗效及并发症发生情况，并进行定期随访。结果引流挂线组的肛管锁眼畸形及肛门失禁发生率明显低于切割挂线组，且术后疼痛的发生明显减少，而且治愈率也没有明显降低。结论引流挂线治疗高位肛瘘及高位脓肿较传统的切割挂线能更好地保护肛直环完整性，能相对较好地保护肛门括约肌功能，减少肛门失禁的发生。

Therapeutic effects of inferior incision combined with drainage thread-drawing on high anal fistula and high crissum abscess

Objective It is to observe the curative effect of inferior incision combined with drainage thread-drawing on high anal fistula and high crissum abscess. Methods Using randomized controlled, large sample, prospective study, multicenter tri- al design method, 193 patients with high anal fistula and high crissum abscess were randomly divided into contradrainage and thread drawing group and cut thread drawing group, which were treated with drainage thread-drawing（ loose thread-drawing） and incision thread-drawing（ tight thread-drawing） methods respectively on the basis of right operation of internal opening. Af- ter operation ,the therapeutic effects and the occurrence of complications were observed and follow-up visit was done at fixed period. Results Compared with traditional incision thread-drawing, drainage thread-drawing can decrease the deformity of anal tube lock hole, reduce the occurrence of anal incontinence as well as relieve pain, reduce the trauma, and the cure rate was not significantly reduced. Conclusion Compared with traditional incision thread-drawing, drainage thread-drawing can more effectively protect the integrality of anal straight ring and the function of anal sphincter and reduce the occurrence of anal incon- tinence in the treatment of high anal fistula and high crissum abscess.