Ⅰ期根治手术结合INS治疗肛周脓肿并糖尿病疗效观察及安全性评价

目的探讨Ⅰ期根治手术结合INS（胰岛素）治疗肛周脓肿并糖尿病的临床疗效。方法肛周脓肿并糖尿病患者126例随机分为两组,试验组63例采用Ⅰ期根治手术结合INS治疗,对照组一63例采用Ⅱ期手术结合INS治疗,另外选择肛周脓肿63例作为对照组二采用Ⅰ期根治术治疗。结果试验组痊愈29例,显效23例,有效9例,无效1例;住院费用4033.93±506.08元;住院日15.19±1.54d;疗程23.14±1.88d;术后并发症（尿潴留19例）。对照组一痊愈13例,显效22例,有效27例,无效2例;住院费用5741.30±536.91元;住院日19.33±3.29d;疗程27.52±3.38d;术后并发症（尿潴留20例）。对照组二痊愈25例,显效22例,有效16例,无效0例;住院费用3790.74±515.40元;住院日14.41±1.81d;疗程21.46±1.79d;术后并发症（尿潴留21例）。3组术后均无感染、出血及后遗症发生,亦无不良事件和生化检查异常。结论Ⅰ期根治手术结合INS治疗肛周脓肿并糖尿病疗效满意,可以降低住院费用,缩短住院时间,避免两次手术,而且安全可靠,基层医院在肛周脓肿并糖尿病的诊疗过程中是可以一次手术治愈的。

The curative effect and safety evaluation of treating perianal abscess with diabetes by one-stage operation and INS

Objective To understand the clinical effects of perianal abscess with diabetes mellitus treated with surgery and INS and to evaluate its safety.Methods According to the China＇s diabetes prevention and control guidelines and Guidelines for diagnosis and treatment of perianal abscess（2006）,189 cases were collected.These cases are divided into three groups（experimental group,control group 1 and control group 2） randomly and Single-blind.Experimental group including 63 patients were treated by the one-stage operation and INS;control group 1 including 63 patients were treated by phase 2 surgery and INS;control group 2 including 63 patients were treated by one-stage operation.Results Experimental group（29 recovered cases,23 excellent cases,9 effective cases,1 invalid cases,hospitalization expenses 4033.93 ± 506.08 RMB,hospitalization days 15.19±1.54,days of treatment 23.14±1.88,postoperative complications 19 cases of urine retention）.Control group 1（13 recovered cases,22 excellent cases,27 effective cases,2 invalid cases,hospitalization expenses 5741.30±536.91 RMB,hospitalization days 19.33±3.29,days of treatment 27.52±3.38,postoperative complications 20 cases of urine retention）.Control group 2（25 recovered cases,22 excellent cases,16 effective cases,no invalid cases,hospitalization expenses 3790.74±515.40 RMB,hospitalization days 14.41±1.81,days of treatment 21.46±1.79,postoperative complications 21 cases of urine retention）.No postoperative infection,bleeding,sequela,adverse events and abnormal laboratory results were found in t hree groups.Conclusion One stage operation and ins get satisfactory effects in perianal abscess with diabetes mellitus,which reduced hospitalization costs,shortened hospital days,avoided two operations and safe and reliable.It has the value of application in primary hospital.