瘘管切开近段基底、远段全层缝合内口引流术治疗低位肛瘘的临床观察-中医外科学专业论文.docxVIP

成都中医药大学硕士学位论文 成都中医药大学硕士学位论文 万方数据 万方数据 中文摘要 目的：观察瘘管切开近段基底缝合、远段全层缝合内口引流术与肛瘘切开引流术 治疗慢性炎症期低位肛瘘的手术、术后并发症以及疗效情况，评价两种术式的疗 效差别。 方法：制定符合本研究的纳入排除标准，收集成都中医药大学附属医院肛肠科 2 013 年 1 月至 2014 年 7 月符合条件的住院病人 60 例，随机分成试验组与对照组， 各 30 例。试验组应用肛瘘瘘管切开近段基底缝合、远段全层缝合内口引流术， 对照组采用肛瘘切开引流术。观察两组患者手术操作情况、术后疼痛情况、术后 出血情况、手术创面大小、术后合并症、创面愈合情况、术后肛门功能及术后半 年随访复发情况等方面的差异。应用统计学软件 SPSS19.0 对结果进行分析，以 α=0.05 为水准进行双侧检验。 结果：两组患者在治愈率方面无统计学差异(P＞0.05)，而在术后继发出血情况、 创面愈合时间、术后瘢痕面积大小等方面观察组明显优于对照组，存在显著性差 异(P＜0.05)；手术时间对照组短于观察组(P＜0.05）；而在术后疼痛、切口水 肿、肛门功能及随访半年复发情况等方面两组无显著性差异(P＞0.05)。 结论：应用瘘管切开近段基底缝合、远段全层缝合内口引流术治疗低位肛瘘，安 全可行，可以有效治疗肛瘘，手术方式相对简单易于掌握，可操作性强，有效的 缩短了切口愈合时间，手术瘢痕小，能更好的保护肛门形态与功能，是治疗慢性 炎症期低位肛瘘的一种良好的术式。 关键词：低位肛瘘；基底缝合；远段全层缝合 1 Abstract Objective : To compare the curative of two kinds of operation method through observe the different clinical curative effect of anal fistula incision operation with the basal layer suture in the anal canal section ,the full-thickness suture i ncision beyond the anal edge and drainage by inner opening and fistulotomy i n the treatment of non infection period of low anal fistula. Methods:60 hospitalized cases meeting criteria were collected from January, 20 13 to July, 2014 in anus bowel division of Chengdu University of TCM Hospi tal. These cases were randomly divided into the observation group and the con trol group , The operation of the observation group were anal fistula incision operation with the basal layer suture in the anal canal section ,the full-thickne ss suture incision beyond the anal edge and drainage by inner opening while t he operation of the control group were fistulotomy .To observe and compare t he difference between the observation group and the control group in difficult y of the operation ,postoperative pain ,postoperative blood loss , the postoperati ve complication , wound healing time , injury anal function and the recurrence rare during the follow-up half a year.data was analyz