对口切开旷置垫棉法结合高位松挂线术治疗高位复杂性肛瘘的临床观察

目的:观察对口切开旷置垫棉法结合高位松挂线术治疗高位复杂性肛瘘的临床疗效。方法:将70例高位复杂性肛瘘患者随机分为治疗组和对照组,每组35例。治疗组采用对口切开旷置垫棉法结合高位松挂线术治疗,对照组采用切开挂线术治疗。比较两组患者的治愈时间、住院时间、治愈率及复发情况,评价两组患者的肛门功能。结果:两组患者的治愈率比较,差异无统计学意义(P0.05)。治疗组患者的术后住院时间及皮筋外肛缘创面愈合时间较对照组明显缩短(P0.01)。术后,治疗组患者的肛管最大收缩压高于对照组(P0.05),肛管最长收缩时间长于对照组(P0.05)。结论:对口切开旷置垫棉法结合高位松挂线术治疗高位复杂性肛瘘可较好地保护肛门功能,缩短住院时间和治愈时间,具有微创化治疗的特点。

Clinical Observation of Counter-incision Exclusion with Cotton Pad and High Loose Seton Thread Therapy for High Complex Anal Fistula

Objective： To observe the clinical effects of counter-incision exclusion with cotton pad and high loose seton thread therapy in treating high complex anal fistula. Methods： Seventy patients with high complex anal fistula were randomly divided into two groups： the treatment group in which 35 cases were treated by counter-incision exclusion with cotton pad and high loose seton thread therapy, and the control group in which 35 cases were treated by incision and thread drawing therapy. The cure time, hospitalization time, curative rate and recurrence were observed. The function of anal sphincter was evaluated. Results： There was no statistical difference between the two groups on the curative rate （ P 〉 0.05 ）. The cure time and hospitalization time of trealment group were shorter than those of the control group （ P 〈 0.01 ）. After operation, the anal maximal contraction pressure of treatment group was higher than that of the control group （ P 〈 0.05 ）, and the anal longest contraction time of treatment group was longer than that of the control group （ P 〈 0.05 ）. Conclusion ： As a minimally invasive therapy, counter-incision exclusion with cotton pad and high loose seton thread therapy can protect the function of anal sphincter, and shorten the hospitalization time and cure time.