隧道式主管拖线术治疗单纯性肛瘘疗效和生活质量评价

Evaluation of Life Quality of Patients with Simple Anorectal Fistula after Treatment by Tunnel Thread-dragging through Fistula Method

目的:探讨与评价肛瘘患者的健康相关生活质量(HRQOL),为全面评价隧道式主管拖线术治疗单纯性肛瘘的效果提供依据。方法:采用前瞻性、多中心、随机、对照的临床试验设计方案。244例高位和低位单纯性肛瘘患者分为治疗组和切开(挂线)法对照组。除以治愈时间、治愈率等为主要观测指标,着重对患者术后生活质量进行评价。结果:低位和高位单纯性肛瘘患者的治愈率在治疗组和对照组间均无统计学差异。低位单纯性肛瘘治疗组平均治愈时间为(22·26±8·67)d,对照组为(31·41±11·39)d。高位单纯性肛瘘治疗组平均治愈时间为(24·73±8·15)d,对照组为(32·20±12·60)d,两组比较均有统计学差异。低位单纯性肛瘘患者各项生活质量积分两组间比较均无明显差异;高位单纯性肛瘘治疗组生活质量、括约功能积分和对治疗信心积分均明显优于对照组(P<0·05);其余各项积分两组间比较则无统计学差异。结论:隧道式拖线术治疗单纯性肛瘘可以明显缩短病程,提高患者生活质量。

Objective To evaluate the life quality of patients with simple anorectal fistula after treatment by tunnel thread-dragging through fistula method Methods In this multi-center, prospective and randomized controlled clinical trials, 244 patients with simple low or high anorectal fistula were randomly divided into study group（ with the method of thread-dragging through fistula） and control group（with the method of incision or thread-drawing）. The healing time and curative rate of anorectal fistula, and the integral calculi of clinical symptom and life quality evaluations before and after treatment were all examined. Results The curative rates of simple low and high anorectal fistula were of no significant differences between the study group and control group. The healing time of simple low anorectal fistula in the study group and the control group were （22.26 ＋ 8.67）d and （31.41 ＋ 11.39）d respectively, while the healing time of simple high anorectal fistula in the study group and the control group were （24.73 ± 8.15）d and （32.20 ±12.60）d respectively,withsignificant differences between the two groups. The integral calculi of life quality between the study group and the control group of simple low anorectal fistula had no significant differences. The integral calculi of anal sphincter function and confidence in treatment in the study group of simple high anorectal fistula were better than those in the control group. Conclu-sion The method of thread-dragging through fistula in treating simple low and high anoreetal fistula can shorten the course of the disease, and improve the life quality of the patients.