开窗对口引流术结合中药治疗高位复杂性肛瘘73例临床观察

目的观察开窗对口引流术结合中药治疗高位复杂性肛瘘的临床疗效。方法将73例高位复杂性肛瘘患者随机分为2组。治疗组36例用开窗对口引流术,术后结合中药伤口换药;对照组37例采用传统低位切开高位挂线术,术后用优锁尔纱条伤口换药,至创面愈合。期间观察记录手术时间、术后伤口疼痛、渗液量、便血、尿潴溜、伤口愈合时间及术后肛门功能等指标。结果治疗组在取得同等疗效的情况下,在减轻术后疼痛,减少渗液量、便血量,缩短伤口愈合时间,保护肛门功能方面均优于对照组(P<0.05)。在手术持续时间和术后尿潴溜发生方面无统计学意义(P>0.05)。结论用开窗对口引流术结合中药治疗高位复杂性肛瘘时在减轻术后伤口疼痛,减少渗液、出血,缩短伤口愈合时间,保护肛门功能方面有明显的优势。

Clinical observation of high complex anal fistula treated by combination of window contra drainage and herbal treatment

Objective To explore the efficacy of high complex anal fistula treated by combination of window contra drainage and wound dressing of herbal treatment. Methods 73 cases of high complex anal fistula were ran- domly divided into two groups. Treatment group received combined therapy of window contra drainage and wound dressing of herbal medicine post operation. Control group received traditional low cut high thread - surgery, wound dressing with gauze of Yousuoer till the wound healing. Operative time, postoperative wound pain, exudate volume and hemafecia, retention of urine, wound healing time- and postoperative anal function were recorded during opera- tion. Results Relieving of the post - operative pain, reducing the amount of exudate, amount of hemafecia, reduc- ing wound healing time, protecting anal function in treatment group were more than those in the control group on the basis of achieving the same effect. There was no difference between two groups on duration of surgery and postoperative incidence of retention of urine （ P 〉 0.05）. Conclusion Combination of window contra drainage and herbal treatment on the treatment of high complex anal fistula has an obvi- ous advantage in reducing postoperative wound pain, reducing exudates and bleeding, shortening healing time and protecting anal function.