一次性根治术治疗肛周脓肿临床观察

目的:观察和评估一次性根治术治疗肛周脓肿的临床疗效.方法:将108例急性肛门直肠周围脓肿病例随机分为一次性根治切开组(观察组,58例)和单纯切开引流组(对照组,50例),观察两组病例创面愈合时间,术后两年内的脓肿复发和肛瘘发生情况.结果:观察组创面愈合时间为(24±4)天;对照组为(20±6)天;两组比较(t=4.0858,P＜0.01),差异有统计学意义;术后脓肿复发或瘘管形成需再次手术的病例观察组为2例,发生率3.4％ (95％ CI=0.46％～12.70％);对照组为35例,发生率70.0％ (95％ CI =57.30％～ 82.70％);两组比较(x2=52.8056,P＜0.01);且两组脓肿复发或瘘管形成发生率的95％CI不重迭.结论:一次性根治术治疗肛门周围脓肿较单纯切开引流术虽然延长创面愈合时间,但能明显降低术后脓肿复发或瘘管形成的复发率.

Clinical Observation of Disposable Radical Operation on Perianal Abscess

Objective： To observe and evaluate the clinical curative effect of disposable radical operation on perianal abscess. Methods： 108 cases with perianal abscess were divided into two groups randomly. 58 cases in treatment group were treated with disposable radical operation, and 50 ones in control group were treated with simple incision and drainage. The postoperative wound healing time was observed and recorded in the two groups, and so were the recurrence of abscess and anal fistula incidence within two years. Results： The postoperative wound healing time was（24 ± 4 ）in treatment group, and （20 ± 6 ）in control group. There was significant difference be- tween the two groups（ t = 4. 085 8 ,P 〈 0. 01 ）. Because of the postoperative recurrence of abscess or operation again of fistula formation 2 cases was in treatment group and the incidence rate was 3.4% （95% CI = 0.46% - 12.70% ）. 35 ones in control group and the incidence rate was 70% （95% CI = 57.30% - 82. 70% ）. There was significant difference between the two groups（ χ2 = 52. 805 6, P 〈0.01 ）. And the occurrence rate of 95% CI in the two groups didn＇t overlap. Conclusion： Although the wound healing time was prolonged more by disposable radical operation than by simple incision and drainage, disposable radical operation can reduce the postoperative recurrence of abscess and anal fistula incidence remarkably.