拖线药线疗法治疗后位马蹄型肛周脓肿前瞻性队列研究.docVIP

拖线药线疗法治疗后位马蹄型肛周脓肿前瞻性队列研究 　　[摘要] 目的 采用前瞻性队列研究方法评价拖线、药线疗法治疗后位马蹄型肛周脓肿的疗效及治疗后肛瘘形成的情况。方法 将2013年7月～2015年2月期间初次入院的50例后马蹄型肛周脓肿患者，分为暴露组和对照组，每组各25例，暴露组采用拖线、药线疗法治疗，对照组采取常规切开引流法治疗，比较两者的一期治愈率以及形成复杂性肛瘘和高位肛瘘的情况。 结果 暴露组的一期治愈率为60.0%，对照组的一期治愈率为32.0%，差异有统计学意义（χ2=3.945，P0.05）；形成肛瘘的病例中，暴露组的复杂性肛瘘病例占20.0%，对照组病例中，复杂性肛瘘病例占88.2%，差异有统计学意义（P0.05）；而暴露组病例中，高位肛瘘病例占10.0%，对照组高位肛瘘病例占52.9%，差异有统计学意义（P0.05）。 结论 拖线、药线疗法治疗后位马蹄型肛周脓肿不仅提高一期治愈率，而且有效减少形成复杂性肛瘘或高位肛瘘的可能性。 　　[关键词] 拖线；药线；后位马蹄型肛周脓肿；前瞻性研究；队列研究 　　[中图分类号] R657.15 [文献标识码] B [文章编号] 1673-9701（2016）21-0046-04 　　[Abstract] Objective To investigate efficacy and formation of anal fistula of pull-thread and medicated-thread therapy in the treatment of posterior horseshoe-shaped perianal abscess with prospective cohort study. Methods 50 patients with horseshoe-shaped posterior perianal abscess who were hospitalized from July 2013 to February 2015 were divided into exposure group and control group， each of 25 cases. The exposure group was treated with pull-thread and medicated-thread therapy， the control group was treated with conventional incision and drainage. The cure rate and formation of anal fistula were compared. Results The cure rate was 60.0% in exposure group and 32.0% in control group， there was significant difference between the two groups（χ2=3.945， P0.05）. The cases with complex anal fistula accounted for 20.0% of all cases in exposure group who had anal fistula after the therapy， and those were 88.2% in control group. There was significant difference between the two groups（P0.05）. The cases with high anal fistula accouted for 10.0% in all cases of exposure group who had anal fistula after the therapy， and those were 52.9% in control group. Also the difference was significant（P0.05）. Conclusion The pull-thread and medicated-thread therapy can improve the cure rate for horseshoe-shaped posterior perianal abscess and reduce the incidence of complex anal fistula or high anal fistula after the therapy. 　　[Key words] Pull-thread； Medicated-thread；