主灶切开挂线支管开窗对口引流治疗高位复杂性肛瘘

为提高高位复杂性肛瘘的疗效，最大限度地减轻术后肛门功能障碍，减少并发症，将128例高位复杂性肛瘘分为治疗组和对照组。治疗组68例采用主灶切开挂线支管开窗对口引流治疗，对照组采用传统的切开挂线术治疗。结果显示，治疗组68例一次性手术治愈66例，2例行二次手术后治愈，一次性治愈率97％；对照组60例一次性手术治愈55例，经二次手术治愈5例，一次性治愈率91．7％。随访1年，治疗组复发3例，对照组复发8例。治疗组平均疗程28．6d，对照组平均疗程39．5d（P〈0．01）。治疗组术后出血3例，对照组11例；治疗组无肛门功能障碍，对照组有肛门功能障碍8例；术后并发症发生率治疗组明显低于对照组（P〈0．01）。结果表明，主灶切开挂线支管开窗对口引流治疗高位复杂性肛瘘，具有治愈率高、复发率低、出血少、疗程短，无肛门功能障碍等优点。

Incision Thread Drawing for Main Tract and Windowing Counterdrainage for Branch Fistula Tract in the Treatment of High Complex Anal Fistula

In order to enhance the therapeutic effect of complex anal fistula,to relief postoperative dysfunction of anus to the maximum,to reduce complication,authors divided 128 patients with high complex anal fistula into two groups：treatment group （ n = 68） subjected to the procedure of incision thread drawing for main tract and windowing counterdrainage for branch fistula tract,while control group （ n=60） to routine incision thread drawing. As results,in treatment group 66 cases were cured primarily,rest 2 cases cured after secondary operation,thus primary curative rate was 97%;in control group 55 cases,5 cases and 91.7%, correspondinaly;follow-up of 1 year found that 3 cases of treatment group and 8 cases of control group had recurrence;average treatment course in treatment group was 28.6 days, while in control group, was 39.5 days（ P〈0.01）;as far as the incidence of postoperative complication,treament group was significantly lower than control group （ P〈0.01） ：bleeding,3 cases vs 11 cases;dysfunction of anus,0 case vs 8 cases. Results show that the procedure of incision thread drawing for main tract and windowing counterdrainage for branch fistula tract in the treatment of high complex anal fistula has such advantages as high curative rate, low recurrence rate, less bleeding, shorter treatment course, and no dysfunction of anus, etc.