松紧结合挂线法治疗高位肛瘘对肛门功能的影响

目的:比较松紧结合挂线和传统挂线疗法对高位肛瘘患者术后肛门功能Wexner评分及肛肠动力学的影响.方法:选取2018年1月—2020年1月于湖南省浏阳市中医医院肛肠科住院的高位肛瘘住院患者60例,随机分为对照组及治疗组,每组30例,对照组采用传统挂线法,治疗组采用松紧结合挂线疗法,比较两组患者术后总体有效率、肛门功能W...

Impacts of Loose Thread-drawing Combined with Tight Thread-drawing on Anal Function and the Changes of Anorectal Pressure in the Treatment of High Anal Fistula

Objective To compare the effects of elasticity combined with hanging thread and traditional hanging thread therapy on Wexner score and anorectal dynamics of postoperative anal function in patients with high anal fistula.Methods Sixty patients of high anal fistula were randomized into a control group and a treatment group,which 30 cases in each one.In the control group,the traditional thread-drawing was applied,while in the treatment group,the loose thread-drawing combined with tight thread-drawing was used.The total clinical therapeutic effects,Wexner score and the changes of anorectal dynamic indicators which included AMCP(Anal Maximal Contraction Pressure,AMCP),ARP(Anal Rest Pressure,ARP)and RRP(Rectal Rest Pressure,RRP)were compared between the two groups.Results The overall effective rate of the postoperative treatment group was 80%,and the control group was 77%,which the difference was not statistically significant(P>0.05).Postoperative treatment group Wexner score(1.10±3.16)was significantly lower than that of the control group(2.97±4.60)(P<0.05).Anorectal motility index:compared with before treatment,there was no significant difference in AMCP values between the two groups after treatment(P>0.05).The RRP(1.29±0.31)kPa],ARP(15.82±2.55)k P a]values of the treatment group were lower than those of the RRP(1.31±0.19)kPa],ARP(16.45±1.81)kPa]before treatment,which the difference was not statistically significant(P>0.05).The RRP(0.92±0.22)kPa],ARP(12.03±1.81)kPa]of the control group were significantly lower than those of the RRP (1.34±0.31) kPa], ARP (17.04±1.12) kPa] values before treatment (P <0.05). The RRP andARP values of the treatment group after treatment were significantly lower than those of the control group (P <0.05). Conclusion Compared with traditional thread-hanging therapy, elasticity combined with thread-hanging canprotect the postoperative anal functional structure and function of patients with high anal fistula better, therebyreducing the incidence of anal incontinence.