肛周脓肿微创置管连续冲洗加负压引流临床研究.docVIP

肛周脓肿微创置管连续冲洗加负压引流临床研究 　　摘要：目的：观察肛旁置管连续冲洗加负压引流治疗肛周脓肿的疗效。方法：将180例肛周脓肿患者随机分为治疗组和对照组，各90例，治疗组采用腔内置管冲洗加负压引流术，对照组根据脓肿情况选用传统切开引流或根治手术。观察两组患者术后脓肿复发率、肛瘘的发生率、创面愈合时间、术后疼痛、住院时间及住院费用等。结果：两组患者术后均随访半年，其脓肿复发率及肛瘘形成率差异无统计学意义（P0.05）；治疗组患者在愈合时间、住院时间、治疗费用及术后疼痛方面均优于对照组，差异具有统计学意义（P0.05）。结论：腔内置管冲洗加负压引流手术治疗肛周脓肿不仅可以达到和传统经典术式一样的治疗效果，而且患者术后恢复快，痛苦小，极大的缩短了住院时间，降低了医疗费用。 　　关键词：肛周脓肿；微创；置管负压引流术 　　四川省卫生厅科研课题，课题编号：120388 　　Abstract： Objective： To observe the therapeutic effect of catheter continuous douching and negative-pressure？drainage on perianalabscess. Methods： 180 perianalabscess patients were randomly divided into “Treatment Group” and “Reference Group” with 90 patients each. Those in Treatment Group were treated with catheter continuous douching and negative-pressuredrainage while those in Reference Group were treated with incision drainage or traditional radical operation according to vomica severity. Then， the two groups were observed and compared in post-operative reoccurrence rate of perianalabscess， the occurrence rate of anal fistula， wound healing time， pain intensity， hospital stays and hospitalization costs. Results： After a half-year follow-up ， it was found that the difference between the two groups in the post-operative reoccurrence rate of perianalabscess and the occurrence of anal fistula was statistically meaningless （P0.05）； the Treatment Group performed better than the Reference Group in wound healing time， pain intensity， hospital stays and hospitalization costs.The difference was statistically meaningful （P0.05）. Conclusion： This research concludes that compared with traditional operation， catheter continuous douching and negative-pressuredrainage not only shows equally great therapeutic effect but also benefits patients with quicker wound healing， lighter pain， shorter hospital stays and lower hospitalization costs. 　　Keywords：perianalabscess； minimally invasive surgery； negative-pressuredrainage 　　肛周脓肿是肛肠科临床常见疾病，占外科疾病的3～5%，占肛肠疾病的8～25%，多见于20岁～40岁的男性，男女发病比例约为3～4：1[1]