分期和同期瘘管外切联合松挂线手术治疗复杂性肛瘘合并肛周脓肿的效果对比

Comparison of the Effect of Staged and Simultaneous Fistula Circumcision Combined with Thread Loosening Surgery in the Treatment of Complex Anal Fistula Combined with Perianal Abscess

目的探究分期和同期瘘管外切联合松挂线手术治疗复杂性肛瘘合并肛周脓肿的效果.方法选择2020年11月—2021年11月本院收治的复杂性肛瘘合并肛周脓肿患者70例为研究对象,根据随机数字表法将其分为两组.对照组35例采用一期脓肿切开联合二期肛瘘处理的分期治疗,观察组35例采取同期瘘管外切联合松挂线手术治疗.比较两组患者的临床疗效、相关治疗指标及并发症发生率.结果观察组的治疗总有效率为97.14%,高于对照组的91.43%,但组间比较,差异无统计学意义(P>0.05).观察组的手术时间、住院时间、切口愈合时间分别为(39.88±5.42)min、(5.52±1.16)d、(6.61±1.07)d,均短于对照组的(45.03±6.13)min、(10.46±2.32)d、(18.25±3.34)d,组间差异有统计学意义(P<0.05).观察组的并发症发生率为5.71%,低于对照组的14.29%,差异有统计学意义(P<0.05).结论分期治疗和同期瘘管外切联合松挂线手术治疗复杂性肛瘘合并肛周脓肿的疗效相近,但同期治疗的安全性更高,整体治疗时间更短,可提高治疗效率,促进患者康复.

Objective To investigate the effect of staged and simultaneous fistula circumcision combined with thread loosening surgery in the treatment of complex anal fistula with perianal abscess.Methods 70 patients with complex anal fistula complicated with perianal abscess treated in our hospital from November 2020 to November 2021 were selected as the research objects,and they were divided into two groups according to the random number table method.The control group of 35 cases was treated by one-stage abscess incision combined with two-stage anal fistula,while the observation group of 35 cases was treated by simultaneous fistula circumcision combined with thread loosening surgery.The clinical efficacy,related treatment indicators and incidence of complications were compared between the two groups.Results The total effective rate of the observation group was 97.14%,which was higher than 91.43%of the control group,but there was no significant difference between the two groups(P>0.05).The operation time,hospital stay and wound healing time of the observation group were(39.88±5.42)min,(5.52±1.16)d and(6.61±1.07)d,respectively,which were shorter than(45.03±6.13)min,(10.46±2.32)d and(18.25±3.34)d of the control group,the differences between the groups were statistically significant(P<0.05).The complication rate in the observation group was 5.71%,which was lower than 14.29%in the control group,and the difference was statistically significant(P<0.05).Conclusion Staged and simultaneous fistula circumcision combined with thread loosening surgery have similar efficacy in the treatment of complex anal fistula complicated with perianal abscess,but the simultaneous treatment has higher safety and shorter overall treatment time,which can improve the treatment efficiency and promote the rehabilitation of patients.