二种手术方式治疗高位复杂性肛瘘的疗效比较.pdfVIP

· 12· 山西医药杂志2008年1月第37卷第1期 ShanxiMed J，January 2008，Vo1．37，№．1 二种手术方式治疗高位复杂性肛瘘的疗效比较 中国医科大学附属第四医院(110032) 李春雨 张丹丹 王 军 徐晓叶 范 庆 辽 宁 中 医 药 大 学 聂 敏 【摘 要】 目的 对比观察切开挂线对口引流术与传统切开挂线术治疗高位复杂性肛瘘的临床效果。方法 91例均为高位复杂性肛瘘住院患者，采用随机分组法分为切开挂线对口引流术组(治疗组)46例，切开挂线术 组(对照组)45例，比较两组术后疗效。结果 两组患者均近期治愈；与对照组相比，治疗组患者术后肛瘘复发 率、创面愈合时间、住院时间明显低于对照组(P0．05)。术后随访1～4年，随访78例，无一例发生肛门失禁、 肛门狭窄及肛门畸形等；治疗组无复发，对照组有2例复发，经扩创换药痊愈。肛门功能检测结果：治疗组手术前 后差异无统计学意义，对照组手术后低于手术前，差异有统计学意义(P0．05)。结论 切开挂线对口引流术治 疗高位复杂性肛瘘手术一一次成功，提高了治愈率，减少了复发率，并保护了肛门括约肌的功能及肛周皮肤的完整 性，疗程短，痛苦少。 【关键词】直肠瘘；挂线法；治疗结果 Effect comp~ ,n between two ways of operations in the treatment of high complex anal fistula LI C~un-yu ， 4 rGDan—dan，WANGJun，XUXiao-ye，F ，NIE Min． P Fourth Affiliated Hos~ml，China Medi— cal University，Shenyang 110032，China 【Abstract】 Objective To comparatively observe the clinical effect of operations between the incision，thread- drawing and counter drainage operation and the traditional operation in the treatment of high complex anal fistula．Meth- ods Ninety-one cases of high complex anal fistula patients in hospital were grouped randomly．There were 46 of the 91 cases accepted the incision，thread—drawing and counter drainage operation(the treatment group)，while 45 cases accept— ed the traditional operation(the control group)．And we compared the post—operation effect between the two groups．Re· suits The patients of the two groups were all cured recently．Compared with the control group，the rate of relapse of anal fistula，the time of wound concremence and the time of in b~3spital were lower obviously in the treatment group(P 0．05)，Post—operation follow-up was 1～4 years，and there was no anal incontinence，anal stricture，anal deformity and anal relapse，etc．in 78 cases which were in follow-up．There