湿润烧伤膏在肛瘘切除术后创面中的应用效果分析

Clinical Efficacy of MEBO in the Treatment of Postoperative Wounds of Anal Fistulectomy

目的分析湿润烧伤膏在肛瘘切除术后创面中的应用效果。方法选取2022年1月至2022年12月铜陵市人民医院收治的64例单纯性肛瘘患者作为研究对象,按照肛瘘术后创面不同换药方法将其分为观察组(32例)和对照组(32例),观察组患者肛瘘切除术后创面使用湿润烧伤膏药纱条换药治疗,对照组患者肛瘘切除术后创面使用医用凡士林纱条换药治疗,对比观察两组患者术后创面愈后瘢痕增生情况及排便情况。结果术后3个月,观察组患者和观察者瘢痕评估量表(POSAS)的患者瘢痕评估量表中疼痛、颜色、硬度、厚度、自我观感、总体评价评分均明显低于对照组(Z=-2.229、-4.453、-6.508、-6.788、-6.504、-6.760,P=0.026、P<0.001、P<0.001、P<0.001、P<0.001、P<0.001),而瘙痒评分与对照组无明显差异(Z=-0.673,P=0.501);POSAS的观察者瘢痕评估量表中血管分布、色泽、厚度、粗糙度、柔软度、表面积、总体评价评分均明显低于对照组(Z=-4.192、-4.282、-5.240、-6.881、-6.845、-6.827、-6.767,P均<0.001);Wexner评分明显低于对照组(Z=-2.141,P=0.032)。结论肛瘘切除术后创面使用湿润烧伤膏药纱条换药治疗,能够提高创面愈合质量,有效减轻瘢痕增生程度,促进肛门功能恢复,最大限度避免因瘢痕挛缩影响排便。

Objective To analyze the clinical efficacy of MEBO in the treatment of postoperative wounds of anal fistulectomy.Methods 64 patients with simple anal fistula,admitted to Tongling People’s Hospital from January 2022 to December 2022,were enrolled as research subjects and then divided into the study group(n=32)and the control group(n=32)according to the different wound dressing methods after anal fistulectomy.Patients in the study group were treated with dressing change of MEBO-impregnated gauze after anal fistulectomy,whereas patients in the control group were treated with dressing change of medical Vaseline gauze after anal fistulectomy.Postoperative wound scar hyperplasia and defecation were compared between the two groups.Results On month 3 after operation,patient and observer scar assessment scale(POSAS)scores in terms of pain,color,hardness,thickness,self-perception,and overall evaluation of patients in the study group were significantly lower compared with the control group(Z=-2.229,-4.453,-6.508,-6.788,-6.504 and-6.760,P=0.026,P<0.001,P<0.001,P<0.001,P<0.001,P<0.001),but there was no significant difference in POSAS itching score between the two groups(Z=-0.673,P=0.501);the POSAS scores in terms of vascular distribution,pigmentation,thickness,roughness,softness,surface area,and overall evaluation of patients were also significantly lower in the study group(Z=-4.192,-4.282,-5.240,-6.881,-6.845,-6.827 and-6.767,all P<0.001).The Wexner score of patients in the study group was significantly lower than that in the control group(Z=-2.141,P=0.032).Conclusion The dressing change of MEBO-impregnated gauze for the postoperative wound of anal fistulectomy can improve the quality of wound healing,effectively reduce the degree of scar hyperplasia,promote anal function recovery,and minimize the impact of scar contracture on defecation.