保留括约肌虚挂线法治疗高位肛周脓肿

目的探讨保留括约肌虚挂线法治疗高位肛周脓肿的临床疗效。方法 2009年10月-2010年10月采用随机对照试验,对52例高位肛周脓肿患者施行手术治疗,其中保留括约肌虚挂线法(治疗组)26例,切开挂线引流法(对照组)26例。对两组患者术后6个月肛瘘发生率、切口愈合时间、术后1～15 d每晚疼痛视觉模拟评分(VAS)和术后6个月痊愈患者肛门功能后遗症发生率进行比较。结果术后6个月,治疗组和对照组肛瘘发生率分别为4.0%和3.8%,差异无统计学意义(P>0.05)。术后7～15 d治疗组VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组切口愈合时间分别为(19.05±6.71)d和(21.42±8.40)d,差异有统计学意义(P<0.05)。术后6个月治疗组痊愈患者肛门功能全部正常,对照组后遗症发生率为12.0%,两组比较差异有统计学意义(P<0.05)。结论保留括约肌虚挂线治疗在术后疼痛、切口愈合时间和保护肛门功能等方面明显优于切开挂线引流治疗,是一种治疗高位肛周脓肿较为理想的方法。

Clinical E cacy of Sphincter-retaining and Loose-seton erapy in Treating Patients with High Perianal Abscess

Objective To investigate the clinical efficacy of sphincter-retaining and loose-seton therapy in treating high perianal abscess.Methods Using randomized controlled trial,52 patients with high perianal abscess were randomly assigned to treatment group(n=26) treated with sphincter-retaining and loose-seton therapy and the control group(n=26) treated with perianal abscess radical surgery.The incidence of anal fistula 6 months after the treatment,healing time of incision,VAS scores of night pain 1 to 15 days after treatment,and sequelae of anal function 6 months later were observed and compared.Results Six months after treatment,the incidences of anal fistula of the treatment group and the control group were respectively 4.0% and 3.8%(P > 0.05).The healing time of incision and night pain score of the surgery day and the 14 days after operation in the treatment group were shorter or slighter compared with those in the control group(P < 0.05).After six-month follow-up,the anal function of treatment group was normal,and the control group had a 12.0% incidence of complications,the difference of which was of statistical significance(P < 0.05).Conclusion The sphincterretaining and loose-seton therapy on high perianal abscess is better than radical surgery in terms of postoperative pain, healing time of incision and protection of anal function.