经括约肌间瘘管结扎术治疗高位单纯性肛瘘效果.docVIP

经括约肌间瘘管结扎术治疗高位单纯性肛瘘效果 　　[摘要]目的 探讨经括约肌间瘘管结扎术（LIFT）治疗高位单纯性肛瘘的临床效果。方法 选取2014年1月～2016年12月我院收治的高位单纯性肛瘘122例，随机分为对照组和观察组，每组61例，其中对照组予以传统切开挂线法治疗，观察组采用LIFT术治疗。比较两组的治疗效果。结果 观察组术后VAS评分、疼痛持续时间、创口愈合时间、瘢痕长度及Wexner评分均显著低于对照组（P0.05）。结论 对于高位单纯性肛瘘患者，LIFT与传统切开挂线法疗效一致，但在减轻术后疼痛程度、缩短疼痛时间、促进创面愈合、保护肛门功能方面更具优势，值得推广 [关键词]高位单纯性肛瘘；经括约肌间瘘管结扎术；切开挂线术；疗效 [中图分类号] R657.16 [文献标识码] A [文章编号] 1674-4721（2017）04（b）-0048-03 The clinical efficacy of LIFT on simple high anal fistula ZHAO Jun-min1 HU Peng-cheng2 1.Department of General surgery，Dongxiang District Hospital of Traditional Chinese Medicine in Jiangxi Province，Fuzhou 331800，China；2.Department of TCM Internal Medicine，Dongxiang District Hospital of Traditional Chinese Medicine in Jiangxi Province，Fuzhou 331800，China [Abstract]Objective To investigate the clinical effect of LIFT for simple high anal fistula.Methods 122 patients with simple high anal fistula in our hospital from January 2014 to December 2016 were randomly divided into control group and observation group，61 cases in each group.The control group underwent fistulotomy and cutting seton，the observation group was treated with LIFT.The therapeutic effects of the two groups were compared.Results The postoperative VAS score，duration of pain，wound healing time，scar length and Wexner scores of the observation group were significantly lower than control group （P0.05）.Conclusion For patients with high anal fistula，LIFT and traditional fistulotomy and cutting seton have the same effect，however，LIFT has the advantages of reducing the degree of postoperative pain，shortening the time of pain，promoting wound healing and protecting anal function.It′s worth popularizing. [Key words]Simple high anal fistula；LIFT；Fistulotomy and cutting seton；Curative effect 肛瘘是临床常见肛肠疾病之一，以溢脓流液、时闭时溃、经久不愈等为症状特点[1]。肛瘘多由原发性内口、继发性外口、瘘道3部分组成，临床上将瘘管穿过外括约肌深层以上，仅有单一内口、外口和瘘管的情况称作高位单纯性肛瘘[2-3]，如不采取及时有效的治疗，高位单纯性肛瘘可反复感染形成支管，最终发展为复杂性肛瘘。目前，对于肛瘘的治疗，手术是唯一的根治方法，传统的肛瘘切开挂线术在治愈肛瘘的同时避免了一次性切开肛门括约肌导致的肛门功能损伤，但术后常常遗留漏气漏液等后遗