括约肌间沟入路、脓腔引流旷置、内口切除治疗骨盆直肠窝脓肿的临床研究-中医外科学专业论文.docxVIP

提要采用设计外口的位置，沿内、外括约肌间沟入路，切开皮肤，分离皮下组织， 提要 采用设计外口的位置，沿内、外括约肌间沟入路，切开皮肤，分离皮下组织， 顺内括约肌外侧间隙分离至骨盆直肠窝，切除内口，并将脓腔充分搔刮后旷置，腔 内放置有孔胶管持续引流，结合术后祛腐消肿止痛期及活血止痛生肌期的药物换 药，旨在提高对骨盆直肠窝脓肿的一次根治率和保护肛门功能，减少并发症发生。 临床治疗观察24例，并与传统的挂线疗法进行对照(24例)，就其治愈率、创面愈 合时间、复发率、术后反应、后遗症及肛管压力变化进行统计学处理比较。结果显 示：两组的治愈率、复发率无明显差异(PO．05)，但治疗组与对照组在创面愈合时 间、术后疼痛、坠胀、排尿障碍及肛管收缩功能、肛管静息压、肛管收缩压方面有 显著差异(P0．01，PO．05)，在肛门溢液、应急性便失禁、便形变细等后遗症上亦 存在显著差异(PO．01，PO．05)，说明治疗组在不降低疗效的同时，对肛门功能的 保护优于对照组。结果显示该方法治疗骨盆直肠窝脓肿是一种能够较好的保护肛门 功能，减少复发率及后遗症的新疗法及合理术式。 关键词骨盆直肠窝脓肿；手术；括约肌问隙 此课题为青岛市卫生局有资助的课研课题 C1 C1 inicaI Study On Treatment Of PeIvi rectal Abscess With Inci sion And Drainage Of The I nternaI Mouth Of Abscess AIong Inter MuscuIar Septum Between The Sph i ncter I nternas And The Sph i ncter Externus SpeciaI ity：TOM’s surgery． Tutor：Professor Ding Ke Author：Zhao Gang Abstract In the operation，the place of the external mouth of abscess was designed，the skin was cut along inter muscular septum between the sphincter internus and the sphincter externus，the subcntaneous tissues were separated along the lateral clearance of the sphincter internus to the pelvirectal fossa，then the internal mouth of abscess was cut．The vomica was 1eared to idle after being scraped fully，and the pus was drained perennially with fenestrated tube．After the operation，the drugs for expelling decay in vomica and subduing swelling and the drugs for promoting blood circulation to stop pain and regenerating the tissue was used．for improving the momentary radical rate of the disease，protecting the function of the anus and decreasing the OCCUrrence of its complication．Twenty—four case of the pelvirectal abscess was treated，contrasted with the control group with the 1 igation therapy．The results showed that there were no obviOUS different in the cure rate and the reoccurrence rate between the treatment group and the control group，but in the healing time of surface of mound，pain after the operation，falling turgor，urinary dysfunction and contract function of anal ca