经括约肌间瘘管结扎术治疗肛瘘的效果及对肛肠动力学指标的影响

目的探讨经括约肌间瘘管结扎术治疗肛瘘的效果及对肛肠动力学指标的影响。方法选取2017年1月至2018年10月于我院行手术治疗的105例肛瘘患者作为研究对象,根据随机数字表法将其分为对照组(52例)与研究组(53例)。对照组给予肛瘘切除术治疗,研究组给予经括约肌间瘘管结扎术治疗。比较两组治疗后的临床症状情况,治疗前、后的肛门功能、肛肠动力学指标,治疗效果及随访结束后的复发情况。结果治疗后,研究组的疼痛、水肿和创面渗出评分均明显低于对照组(P<0.05)。治疗后,两组的Wexner评分明显低于治疗前,且研究组低于对照组(P<0.05)。治疗后,两组的肛管最大收缩压明显高于治疗前,肛管最长收缩时间明显长于治疗前,直肠静息压和肛管静息压均明显低于治疗前(P<0.05);治疗后,研究组的直肠静息压和肛管静息压均明显低于对照组(P<0.05)。研究组的治疗总有效率明显高于对照组,随访结束后的复发率明显低于对照组(P<0.05)。结论经括约肌间瘘管结扎术治疗肛瘘的效果显著,且对患者肛肠动力学的影响小,值得临床推广应用。

Effect of ligation of intersphincteric fistula tract in the treatment of anal fistula and its influence on anorectal dynamic index

Objective To investigate the effect of ligation of intersphincteric fistula tract in the treatment of anal fistula and its influence on anorectal dynamic index.Methods A total of 105 patients with anal fistula who were operated in our hospital from January 2017 to October 2018 were selected as the study objects,and they were divided into control group(52 cases) and study group(53 cases) according to the random number table method.The control group was treated with resection of anal fistula,and the study group was treated with ligation of intersphincteric fistula tract.Clinical symptoms after treatment,anal functions,anorectal dynamic indexes before and after treatment,treatment effects and recurrence after follow-up were compared between the two groups.Results After treatment,the scores of pain,edema and wound exudation in the study group were significantly lower than those in the control group(P<0.05).After treatment,the scores of Wexner in the two groups were significantly lower than those before treatment,and that in the study group was lower than the control group(P<0.05).After treatment,the maximum anal systolic pressure in the two groups were significantly higher than those before treatment,the longest anal systolic time were significantly longer than those before treatment,the rectal resting pressure and anal resting pressure were significantly lower than those before treatment(P<0.05);after treatment,the rectal resting pressure and anal resting pressure in the study group were significantly lower than those in the control group(P<0.05).The total effective rate of treatment in the study group was significantly higher than that in the control group,and the recurrence rate after follow-up was significantly lower than that in the control group(P<0.05).Conclusion The ligation of intersphincteric fistula tract in the treatment of anal fistula has significant effect,and it has little influence on anorectal dynamics of patients,which is worthy of clinical promotion and application.