改良LIFT 治疗复杂性肛瘘的临床疗效研究

目的 比较改良经括约肌间瘘管结扎术（LIFT）和切开挂线术治疗复杂性肛瘘的临床疗效。方法 将80 例复杂性肛瘘患者随机分为治疗组和对照组，治疗组采用改良LIFT，对照组采用切开挂线术。对两组疗效、复发率及并发症等进行对比观察。结果 两组患者在手术时间、愈合时间、术中出血量、术后创面面积、术后疼痛时间、住院时间、总有效率、术后尿潴留、术后感染、术后3 个月复发、术后第7、14天疼痛和首次排便疼痛视觉模拟评分法（VAS）评分及术后肛门失禁Wexner 评分比较，差异有统计学意义（P <0.05）；但在术后第1 天视觉VAS 疼痛评分及术前肛门失禁Wexner 评分比较，差异无统计学意义（P >0.05）。结论 改良LIFT 较传统切开挂线术治愈率高，是治疗复杂性肛瘘的有效术式。

Clinical effect of improved LIFT surgery in treatment of complex anal fistula

Objective To observe the clinical efficacy of improved LIFT surgery and seton therapy in the treatment of complicated anal fistula. Methods A total of 80 patients with complicated anal fistula were randomly divided into treatment group (40 patients) and control group (40 patients). The treatment group was treated with improved LIFT surgery while the control group was treated with seton therapy. Curative effect, recurrence rate and complications were investigated in the two groups. Results There were significant differences in the operation duration, wound healing time, blood loss during operation, postoperative wound surface area, postoperative pain time,time of hospital stay, total effective rate, postoperative urinary retension, postoperative infection, recurrence rate 3 months after operation, the Visual Analog Scale (VAS) scores of piain on the 7th and the 14th postoperative day and at the first defecation after operation, and Wexner score of anal incontinence before operation between the treatment group and the control group (P < 0.05). But there was no significant difference in the VAS score on the 1st day after operation or the Wexner score of anal incontinence before operation (P > 0.05). Conclusions Compared with seton therapy, improved LIFT surgery is very effective in treating complicated anal fistula.