肛门括约肌间切开术治疗高位肛瘘的临床研究

目的:研究肛门括约肌间切开术治疗高位肛瘘之临床疗效.方法:将72例高位肛瘘患者按随机数字表法随机分为对照组(切开挂线术组)和试验组(括约肌间切开术组),各36例.比较两组手术基本情况、临床疗效、肛门功能、创面面积、局部疼痛及并发症等方面的差异.结果:试验组住院时间(8.22±2.10)d,短于对照组的(14.17±2....

Clinical Study of Cutting of Intersphincter Space in the Treatment of High Anal Fistula

Objective To study the clinical effect of cutting of intersphincter space in thetreatment of high anal fistula.Methods According to the method of random number table,72 patients with high anal fistula were randomly divided into control group(cutting seton)(n=36)and experimental group(cutting of intersphincter space)(n=36).The basic situation ofoperation,clinical effect,anal function,wound area,local pain and complications were compared between the two groups.Results The hospitalization time of the test group was(8.22±2.10)days,which was shorter than that of the control group(14.17±2.83)days.The wound healing time in the test group was(35.75±11.15)days,which was shorter than that in the control group(55.69±13.42)days.Three months after operation,the anal resting pressure and the maximum anal systolic pressure in the test group were(58.39±6.72)mmHg and(143.72±8.24)mmHgrespectively,which were higher than those in the control group(51.25±4.33)mmHg and(126.75±11.49)mmHg.Three months after operation,the Wexner score of fecal incontinence in the experimental group was lower than that in the control group(0.56±0.61),which was lower than that in the control group(3.25±0.81).On the day of operation,7 days after operation and 14 days after operation,the wound area of the test group was(10.70±1.67)cm2,(8.34±1.18)cm2 and(6.25±1.13)cm2 respectively,which were smaller than those of the control group(20.52±1.58)cm2,(16.26±2.37)cm2 and(13.98±2.24)cm2 respectively.The pain index of the test group was(3.44±0.91),(4.17±0.77)and(2.64±0.82)at 7 hours,the first defecation and the 7th day after operation respectively,which were lower than those of the control group(6.25±0.73),(7.22±1.20)and(5.28±1.49).The incidence of postoperative complications in the test group was 17%,which was lower than that in the control group(53%)(all P<0.05).There was no significant difference in recurrence rate and clinical curative effect between the two groups(all P>0.05).Conclusion Compared with cutting seton,cutting of intersphincter space in the treatment of high anal fistula has significant advantages such as better maintenance of anal function,less trauma,faster recovery,less pain,less complications and so on.