高位复杂性肛瘘合并脓肿一期与分期手术分析

Empirical Analysis of One-Stage Operation and Staging Operation for High Complex Anal Fistula Combined Abscess

目的比较"一期与分期外切内挂手术"治疗高位复杂性肛瘘合并脓肿的临床疗效。方法将60例高位复杂性肛瘘合并脓肿患者随机分为治疗组40例,采用"一期外切内挂手术";对照组20例,采用"一期脓肿切开,二期外切内挂手术"进行比较观察。结果"一期外切内挂手术"组与对照组的显愈率分别为92.5%和90%,差异无统计学意义(P>0.05),肛门功能情况亦无差异。但两组间的住院费用、创口愈合时间和术后疼痛程度存在显著差异(P<0.05)。结论在治疗高位复杂性肛瘘合并脓肿时,"一期外切内挂手术"与分期手术相比,具有痛苦小、疗程短、肛门功能保护好等优点,一期外切内挂手术方法是能够达到高位复杂性肛瘘根治性手术要求,改善肛瘘患者生活质量的有效手段。

Objective To observe the clinical effect of one-stage and staging extra-dissection operation and intra-seton operation in the treatment of high complex anal fistula combined abscess.Methods Sixty cases with high complex anal fistula were randomly divided into two groups.40 cases in the treatment group were treated with one-stage extra-dissection and intra-seton operation.The other 20 cases in control group were treated with the first stage abscess dissection and the second stage extra-dissection and intra-seton operation.Results The cure rate of the treatment group and the control group was 92.5% and 90% respectively,the difference gad no statistical significance（P0.05）.The anal function of two groups was no difference either.There was significant difference in postoperative pain,healing time and cost of hospitalization between the two groups（P0.05）.Conclusion The one-stage extra-dissection and intra-seton operation is predominant characteristic as the micro-painful or short-course of treatment and anal function protection.It is an effective procedure to achieve radical cure desire and improve patients＇ quality of life for high complex anal fistula combined abscess.