放射状多切口引流治疗蹄铁型肛瘘72例临床观察

Clinical Observation of 72 Cases of Horseshoe Fistula Treated with Radial Multi-Incision and Drainage

目的探讨放射状多切口切开瘘管、对口引流治疗蹄铁型肛瘘的有效性。方法将72例蹄铁型肛瘘患者随机分成两组,其中试验组38例,对照组34例;试验组行放射状多切口引流术切开瘘管、对口引流治疗,对照组行瘘管切开缝合内口引流术。观察两组的治疗效果及术中、术后并发症。结果两组患者组间治疗效果相比,近期疗效无统计学差异;中期疗效试验组明显优于对照组(P<0.05);并发症方面,两组在术中出血、术后出血、术后疼痛、术后感染方面无统计学差异,但试验组术后满意度明显优于对照组(P<0.05)。结论放射状多切口、对口引流术是一种治疗蹄铁型肛瘘简便、有效、准确的手术方法,具有损伤小、操作简便、出血少、患者疼痛轻等优点,适合推广。

Objective To explore the effectiveness of radial multi-incision of fistula and contra-incision drainage in the treatment of horseshoe fistula.Methods 72 cases of horseshoe fistula were divided randomly into two group,33 cases in trial group and 39 cases in control group.In trial group,the cases were treated with radial multi-incision of fistula and contra-incision drainage.In control group,the cases were treated with incision of fistula and closure-internal-incision drainage.The effect of treatment and complications during and after operation were observed in two groups.Results There was no statistical difference in recent efficacy in comparison of two groups.The medium-term efficacy in trial group was superior remarkably to control group（P0.05）.Concerning to complications,there were no statistical differences in during-operation bleeding,postoperative bleeding,postoperative pain and postoperative infection between two groups.But the postoperative satisfaction in trial group was superior remarkably to control group（P0.05）.Conclusion The radial multi-incision of fistula and contra-incision drainage is a kind of simple,effective and accurate surgical means in the treatment of horseshoe fistula,being advantageous at less injury,simple operation,less bleeding and mild pain.It is suitable to be promoted.