肛门直肠周围脓肿一期手术的临床对照研究

Clinical evaluation of postoperative of perianal abscess treated with primary curative incisional drainage

目的观察和评估一期手术治疗肛门直肠周围脓肿的临床疗效。方法258例肛周脓肿患者随机分成两组,包括:一期手术组(PCID组)128例和传统的单纯切开引流组(TID组)130例。观察两组病例的手术时间、手术出血量、术后感染控制时间、住院时间、创面愈合时间、肛门功能障碍、脓肿复发及遗留肛瘘情况。结果PCID组术后脓肿复发需要再次手术者4例(3.1%),而TID组29例(22.3%),两组有统计学差异(P<0.05)。术后遗留肛瘘,PCID组7例(5.47%),而TID组62例(47.69%),两组统计学差异明显(P<0.01)。在手术时间、术中出血量、感染控制时间、住院时间、创伤愈合时间和肛门功能等方面两组没有统计学差异。结论一期手术可以明显减少术后脓肿的复发和遗留肛瘘的发生率,没有增加患者的住院和创伤愈合时间,也没有增加术后感染的扩散和永久性肛门功能障碍的发生。

Objective To evaluate the clinical effects on perianal abscess treated with primary curative incisional drainage （PCID）. Methods 258 patients with perianal abscess were randomly divided into two groups, including Group PCID （128 cases） and Group TID （130 cases）. Group PCID was operated with primary curative incisional drainage, and Group TID was operated with traditional incisional drainage. The rates of recurrence and the residual anal fistula were observed. Results The rate of recurrence in PCID and TID Group was 3.1% and 22.3% （P〈0. 05）, respectively. There was significantly different between the rate of residual anal fistula in PCID （5.47%） and in TID （47.69%） （P〈 0. 01）. Conclusion PCID may reduce the rate of recurrence and residual anal fistula in treating perianal abscess,