直肠黏膜推移皮瓣术治疗高位复杂性肛瘘的临床疗效观察

目的观察直肠黏膜推移皮瓣术（ERAF）在治疗高位复杂性肛瘘（HCAF）中的临床疗效。 方法选取80例高位复杂性肛瘘的患者，随机将其分为观察组40例和对照组40例，观察组采用ERAF、对照组采用松弛挂线术（LST），分析比较两组患者的临床疗效、视觉模拟疼痛评分（VAS）、肛门功能失禁（Wexner）评分、术后复发率。 结果两组患者术后第1天VAS评分比较（t=-1.268，P＞0.05）、术后1年复发率比较（χ²=1.829，P＞0.05），差异均无统计学意义；两组患者住院时间比较（t=-16.464，P＜0.05）、伤口愈合时间比较（t=-12.662，P＜0.05）、术后6个月Wexner评分比较（t=-34.785，P＜0.05）、术后第5天VAS评分比较（t=-8.222，P＜0.05）、术后第7天VAS评分比较（t=-6.056，P＜0.05），差异均具有统计学意义。 结论ERAF可使患者住院时间及伤口愈合时间缩短，减轻患者术后疼痛，肛门失禁评分亦优于LST术式，值得临床中广泛应用。

Clinical effect obesrvation of the treatment of high complex anal fistula with endorectal advancement flap

ObjectiveTo observe clinical effect of endorectal advancement flap (ERAF) for the treatment of high complex anal fistula (HCAF). MethodsEighty patients with high complex anal fistula were randomly divided into observation group 40 cases and control group 40 cases. Patients in observation group were treated with ERAF, while those in control group were treated with loose-seton technique (LST). The cure rate, visual analogue pain score (VAS), anal incontinence score (Wexner scale) and recurrence rate of the two groups were analyzed and compared. ResultsThere were no significant differences in the total cure rate, VAS score on the first day after operation (t=-1.268, P＞0.05) recurrence rate after 1 year (χ²=1.829, P＞0.05). Comparison of two groups:hospital stays (t=-16.464, P＜0.05),wound healing time (t=-12.662, P＜0.05), VAS scores on the 5th day (t=-8.222, P＜0.05)、VAS scores on the 7th day (t=-6.056, P＜0.05) after surgery and the Wexner scores (t=-34.785, P＜0.05) after recovery. ConclusionERAF can effectively treat high complex anal fistula, and it worthy of being widely used in the clinical treatment of high complex anal fistula to preserve anal sphincter function.