直肠内挂线法与切开挂线法治疗肛提肌以上脓肿疗效对比研究

目的观察比较直肠内挂线法与切开挂线法治疗肛提肌以上脓肿的临床疗效。方法将2016年5月—2018年2月在中国中医科学院广安门医院治疗的60例肛提肌以上脓肿患者随机分为观察组和对照组各30例,观察组患者采用直肠内挂线法治疗,对照组患者采用切开挂线法治疗,观察比较2组患者手术相关的各项临床指标(手术时间、住院时间、切口愈合时间)及术后第1天、第7天、第14天肛门疼痛情况,统计2组患者手术后的临床疗效,随访2组患者术后3个月肛门括约肌控便功能。结果观察组患者的手术时间、住院时间、切口愈合时间均显著短于对照组(P均<0.05),术后第1天、第7天、第14天疼痛分级均显著低于对照组(P均<0.05),治疗后的临床总有效率明显高于对照组(P<0.05),且术后3个月的肛门括约肌功能Wexner评分明显低于对照组(P<0.05)。结论直肠内挂线法是一种治疗肛提肌以上脓肿的安全有效的手术方式,具有手术耗时短、住院时间短、切口愈合快、术后疼痛轻、对肛门内外括约肌损伤小等优势,可更好地保护肛门括约肌的控便功能。

Comparative study of the efficacy of rectal thread-ligating therapy and incision thread-ligating therapy in the treatment of abscesses above the levator ani muscle

Objective It is to observe and compare the clinical efficacy of rectal thread-ligating therapy and incision thread-ligating therapy in the treatment of abscesses above the levator ani muscle.Methods Sixty patients with abscesses above the levator ani muscle treated at Guang'anmen Hospital of China Academy of Chinese Medical Sciences from May 2016 to February 2018 were randomly divided into observation group and control group with 30 cases in each group.The observation group was treated with intrarectal thread-ligating therapy,the control group was treated with the incision thread-ligating therapy.The clinical indicators(operation time,hospitalization time,incision healing time)and the anus pain on the 1st,7th,and 14th days after surgery were observed and compared between the two groups.The clinical efficacy of the two groups of patients were assessed,and the function of the anal sphincter in the two groups was followed up in 3 months after surgery.Results The operation time,hospitalization time,and incision healing time in the observation group were significantly shorter than those in the control group(all P<0.05),and the pain grades on the 1st,7th,and 14th days after surgery were significantly lower than those in the control group(all P<0.05),the total clinical effective rate after treatment was significantly higher than that of the control group(P<0.05),and the Wexner scores of anal sphincter function were significantly lower than that of the control group at 3 months after operation(P<0.05).Conclusion Rectal thread-ligating therapy is a safe and effective surgical method for the treatment of abscesses above the levator ani muscle.It has the advantages of shorter operation time,shorter hospital stay,faster incision healing,less postoperative pain,and less damage to the internal and external anal sphincter,it can better protect the anal sphincter control function.