经括约肌间瘘管结扎术联合直肠内推移皮瓣治疗高位复杂性肛瘘的疗效观察

Clinical Efficacy of Ligation of Intersphincteric Fistula Tract Combined with Endorectal Advancement Flap in Treatment of High Complex Anal Fistula

目的:观察经括约肌间瘘管结扎术联合直肠内推移皮瓣治疗高位复杂性肛瘘的临床疗效。方法:将我院收治的68例高位复杂性肛瘘患者随机分为对照组和观察组,每组34例。对照组患者采用经括约肌间瘘管结扎术治疗,观察组患者采用经括约肌间瘘管结扎术联合直肠内推移皮瓣治疗,比较2组患者术后临床疗效、疼痛评分、Wexner失禁评分、并发症及复发率。结果:观察组患者的总有效率明显高于对照组(P<0.05);术后第1天2组患者疼痛评分比较差异无统计学意义(P>0.05),术后第7天观察组患者疼痛评分明显低于对照组(P<0.05);术前2组患者Wexner失禁评分比较差异无统计学意义(P>0.05),术后第7天观察组患者Wexner失禁评分明显低于对照组(P<0.05);观察组患者术后并发症发生率、复发率明显低于对照组(P<0.05)。结论:经括约肌间瘘管结扎术联合直肠内推移皮瓣治疗高位复杂性肛瘘具有疗效好、术后疼痛轻、并发症少、复发率低等优点,值得临床推广应用。

Objective To observe the clinical efficacy of ligation of the intersphincteric fistula tract(LIFT)combined with endorectal advancement flap(ERAF)in the treatment of high complex anal fistula.Methods Total 68 patients with high complex anal fistula in our hospital were randomly divided into the control group and the observation group,34 patients in each group.The control group was treated with LIFT,while the observation group was treated with LIFT combined with ERAF.The postoperative clinical efficacy,pain score,Wexner incontinence score,complications and recurrence rate were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in pain score between the two groups on the first day after operation(P>0.05).The pain score of the observation group was significantly lower than that of the control group on the 7th day after operation(P<0.05).There was no significant difference in Wexner incontinence score between the two groups before operation(P>0.05).The Wexner incontinence score in the observation group was significantly lower than that in the control group on the 7th day after operation(P<0.05).The incidence of postoperative complications and recurrence rate in the observation group were significantly lower than those in the control group(P<o.05).Conclusion LIFT combined with ERAF in the treatment of high complex anal fistula has the advantages of good efficacy,less postoperative pain,fewer complications and low recurrence rate,which is worthy of clinical application.