复杂肛瘘手术方法对比观察

Contrast Observation of Therapeutic Effect of Different Operations on Complex Anal Fistula

目的 探讨不同手术方法治疗复杂性肛瘘的临床疗效和优点。方法 回顾性分析2000年3月～2004年12月复杂性肛瘘患者135例，分别进行切开挂线术、切缝内口引流术、瘘管摘除缝合术、瘘管旷置术等不同手术方法的处理。结果 随访5～10个月（平均7．2个月），切开挂线术37例，复发1例，平均愈舍时间（20．224±5．24）d；切缝内口引流术32例，复发3例，平均愈合时间（22．84±6．66）d；瘘管摘除缝合术34例，复发5例，平均愈合时间（25．56±7．51）d；瘘管旷置术32例，复发6例，平均愈合时间（30．43±10．72）d。结论 低位复杂性肛瘘多采用切缝内口引流术、瘘管摘除缝舍术；高位复杂性肛瘘多采用切开挂线术、瘘管旷置术。

Objective To evaluate the effect and advantages of different operative procedures on complex anal fistula. Methods From April 2000 to June 2004,135 cases with complex anal fistula were analyzed respectively who were treated by incision and thread drawing, incision--suture of internal opening plus drain- age, fistulectomy and primary suture. Results All cases were followed for 5 to 10 months {average 7.2 months}. 37 cases treated by incision and thread drawing with 1 recurred {average healing time 20. 224 ±5.24 days} ;32 cases by incision--suture plus internal opening drainage with 3 recurred（aver- age healing time 22.84± 6.66 days} ;34 cases by fistulectomy and primary suture with 5 recurred{ average healing time 25.56 ±7.51 days};32 cases by fistulotomy with 6 recurred { average healing time 30.43±10.72 days}. Conclusions Low complex anal fistula can be treated by incision--suture plus internal opening drainage of fistulectomy and primary suture, and high complex anal fistula by incision and thread drawing or fistulotomy.