“隧道式拖线法”治疗低位复杂性肛瘘复发原因探析

目的：通过对“隧道式拖线法”治疗低位复杂性肛瘘术后复发的病例进行回顾性研究，提高“隧道式拖线法”治疗低位复杂性肛瘘的手术成功率，减少患者的痛苦。方法：对2007年1月-2012年12月我科运用“隧道式拖线法”治疗低位复杂性肛瘘术后复发的16例病例进行系统性回顾，分析探讨复发原因。结果：“隧道式拖线法”治疗低位复杂性肛瘘复发的主要原因为：原发内口探查处理不当；手术中未彻底处理支管、死腔及窦道；术后创面引流不通畅；术后换药不及时；后期撤除拖线后垫棉压迫不充分。结论：我们需注意术前完善检查、术中仔细处理内口及正规拖线、术后加强换药，并注意在撤线后正确使用垫棉加压法，减少术后复发，进一步提高“隧道式拖线法”治疗低位复杂性肛瘘成功率。

A analysis of treating low anal fistula by tunnel line towing therapy

Objective：To observe tunnel type towing line therapy in treating low complexity anal fistula, improving the tunnel type towing line therapy suaessful rate of surgery in treating low complexity anal fistula, reducing the pain of the patients. Methods：In January 2007-December 2012, 16 cases were treated in tunnel type towing line therapy, and a systematic review was applied on it. Results：The main causes were inappropriate dealing with internal hole, incompletely dealing with pipes, dead space and sinus during surgery, not smooth wound, not timely dressing, incomplete oppression of cotton pad. Conclusion： We need to pay attention to preoperative examination, intraoperative careful handling internal hole and the normal towing line, timely dressing change, and complete oppression of cotton pad should to be payed attention, to reduce the postoperative recurrence, further improving the success rate of tunnel type towing line therapy in treating low complex anal fistula.