传统切开挂线疗法与瘘管旷置术治疗高位复杂性肛瘘的临床研究

目的研究传统切开挂线疗法与瘘管旷置术治疗高位复杂性肛瘘的临床效果,为该类疾病的治疗提供一定的参考。方法将2010年8月至2014年8月入院治疗的96例高位复杂性肛瘘患者随机分为两组,其中对照组仅采用传统切开挂线疗法进行治疗,而观察组采用传统切开挂线疗法和瘘管旷置术进行治疗,比较两组患者的伤口愈合时间及复发情况比较,两组治疗方案临床疗效以及两组患者术后分泌物的分泌量。结果治疗组患者伤口愈合时间[(30.4±10.4)d]长于对照组[(22.6±8.7)d],差异有统计学意义(P0.05),并且治疗组的复发率(4.2%)低于对照组(18.8%),两组比较差异有统计学意义(P0.05)。治疗组总有效率为95.8%,对照组总有效率为85.4%,两组比较差异统计学意义(P0.05);治疗组患者手术后第7、10天分泌物量评分[(4.2±1.1)、(2.5±0.7)分]低于对照组[(5.8±1.3)、(4.7±1.3)分],两组比较差异有统计学意义(P0.05)。结论传统切开挂线疗法与瘘管旷置术联合治疗高位复杂性肛瘘的临床效果显著,虽然患者伤口愈合时间较长,但复发率较低,值得临床推广应用。

Clinical effect of traditional incision seton therapy and fistula exclusion in patients with high complexity anal fistula

Objective To compare the clinical effect of traditional incision seton therapy with fistula exclusion in patients with high complexity anal fistula ,and to provide certain reference for the treatment of the disease .Methods A total of 96 patients with high complexity anal fistula hospitalized from August 2010 to August 2014 were selected and divided into two groups (observation group and control group) .Control group only used traditional incision seton therapy ,and observation group treated with traditional incision seton therapy combined with fistula exclusion .The time of wound healing ,recurrence rates ,effective rates and postoperative secretion were compared between the two groups .Results The time of wound healing of the observation group [(30 .4 ± 10 .4)d] was significantly longer than that of control group[(22 .6 ± 8 .7)d](P<0 .05) ,while the recurrence rate in the observation group (4 .2% ) was significantly lower than that of control group (18 .8% ) (P< 0 .05) .The effective rate of the observation group (95 .8% ) was higher than that of control group (85 .4% ) ,and the difference had statistical significance(P<0 .05) .The score of postoperative secretion of the 7th day (4 .2 ± 1 .1) and the 10th day (2 .5 ± 0 .7) after surgery was significantly less than that of the control group[(5 .8 ± 1 .3) ,( 4 .7 ± 1 .3)](P<0 .05) .Conclusion Traditional incision seton therapy combined with the treatment of the fistula the exclusion in patients with high complexity anal fistula has remarkable clinical effect .Although the wound healing time is longer ,the recurrence rate is lower obviously ,so it is worth of clinical application .