微创手术联合术后地奥司明对肛瘘患者的治疗效果分析

Analysis of the therapeutic effect of minimally invasive surgery combined with postoperative diosmine on patients with anal fistula

目的探讨微创手术联合术后地奥司明对肛瘘患者的治疗效果。方法选取2019年7月至2020年12月商丘市中医院肛肠科收治的140例肛瘘患者,男81例,女59例,年龄(43.1±4.0)岁,年龄范围为23~77岁。按照随机数表法将所有患者随机分为微创组与微创联合药物组,每组70例。微创组给予微创拖线治疗;微创联合药物组在微创组治疗的基础上,术后患者口服地奥司明。术后观察两组患者的治疗效果、创面水肿程度、创面愈合时间、住院时间、肛门控便能力、排便时的疼痛程度、免疫球蛋白A(IgA)及血清淀粉样蛋白A(SAA)水平。结果微创联合药物组有效率[95.7%(67/70)]高于微创组[84.3%(59/70)],差异有统计学意义(P<0.05)。治疗后,微创联合药物组的创面愈合时间、住院时间较微创组短,创面水肿程度评分、控便能力评分、疼痛指数评分均低于微创组,差异均有统计学意义(P<0.05);微创联合药物IgA水平[(1.32±0.03)mg/L]高于微创组[(0.93±0.04)mg/L],SAA水平[(544.86±74.28)μg/L]低于微创组[(754.27±94.76)μg/L],差异均有统计学意义(P<0.05)。结论微创拖线联合术后地奥司明治疗能够明显改善肛瘘患者的创面水肿程度、围术期指标及炎症因子水平,可在临床上广泛应用。

Objective To investigate the therapeutic effect of minimally invasive surgery combined with postoperative diosmine on patients with anal fistula.Methods A total of 140 patients with anal fistula,including 81 males and 59 females,aged(43.1±4.0)years,ranging from 23 to 77 years old,were selected from the department of Proctology,Shangqiu City Hospital of TCM from July 2019 to December 2020.All patients were randomly divided into minimally invasive group and minimally invasive combined drug group,70 cases in each group.The minimally invasive group was treated with minimally invasive dragline therapy.In the minimally invasive group,postoperative patients took diosimine orally on the basis of the minimally invasive group.The therapeutic effect,wound edema degree,wound healing time,hospital stay,anal stool control ability,pain degree during defecation,immunoglobulin A(IgA)and serum amyloid protein A(SAA)levels of the two groups were observed.Results The total effective rate of minimally invasive group[95.7%(67/70)]was higher than that of minimally invasive group[84.3%(59/70)],and the difference was statistically significant(P<0.05).After treatment,the wound healing time and hospital stay in the minimally invasive group were shorter than those in the minimally invasive group,and the score of wound edema degree,fecal control ability and pain index were lower than those in the minimally invasive group,with significant differences(P<0.05).Minimally invasive joint drug IgA level[(1.32±0.03)mg/L]was higher than that in the minimally invasive group[(0.93±0.04)mg/L],SAA level[(544.86±74.28)μg/L]lower than that in the minimally invasive group[(754.27±94.76)μg/L],the differences were statistically significant(P<0.05).Conclusion Minimally invasive line dragline therapy combined with postoperative diosimine therapy can significantly improve the degree of wound edema,perioperative indicators and levels of inflammatory factors in patients with anal fistula,which can be widely used in clinical practice.