肛周脓肿不衍生肛瘘的一次性根治手术

CLINICAL EFFECTS OF RADICAL OPERATION ON INFLAMMATION OF CIRCUMANAL GLAND AND PERIANAL ABSCESS

目的观察一次性手术治疗肛腺炎、肛周脓肿的临床效果。方法新法组:对肛腺炎及肛周脓肿患者采用常规肛门局部麻醉,先找到在肛管处的肛腺内口,切开肛管内口至脓腔口的皮肤,发现近内口的一段纤维管状组织,即发炎的肛腺、肛腺导管,用电离子刀将其直至内口全部彻底切除,充分敞开创口,电凝止血,充填油纱,术后洗浴。传统组行常规的脓肿切开引流术。比较两组肛瘘等发生率。结果传统组:48例患者中,Ⅰ期愈合6例,发生肛瘘者42例(87.5%);新法组:68例患者中,Ⅰ期愈合66例,发生瘘管者2例(2.94%)。两组肛瘘发生率比较有统计学意义(χ2=85.46,P<0.01),新法组低于传统组。结论采用一次性根治手术治疗肛腺炎、肛周脓肿,可最大限度地避免肛瘘发生,减少患者痛苦。

Objective To explore the clinical effects of radical operation on inflammation of circumanal gland and perianal abscess.Methods Routine anal local anesthesia was applied to inflammation of circumanal gland and perianal abscess.The skin from the endostoma of circumanal gland to the opening of circumanal gland was cut open to find the inflamed circumanal gland and its catheter and to remove all of them.Electric coagulation and gauze were used for hemostasia.Postoperative bathing was given to the patients.Results In the routine group of 48 patients,at Stage I,six cases recovered,42 cases suffered from anal fistula（87.5%）.In the new therapy group of 68 patients,at Stage I,66 cases recovered,anal fistula occurred in 2 cases （2.94%）.There existed signifcant differences between the two groups（χ2=85.46,P0.01）.Conclusion The radical operation can be effectively used to treat the inflammation of circumanal gland and perianal abscess and can avoid anal fistula to great extent.