切开双挂线引流术治疗高位后蹄铁型肛周脓肿

An approach in treatment of high posterior perianal abscess of horse shoe shape through incision and double thread drawing drainage

目的探讨高位后蹄铁型肛周脓肿较为可靠有效的手术方式。方法将60例高位后蹄铁型肛周脓肿患者随机分为观察组和对照组,每组各为30例,观察组采用"切开双挂线引流"术式,对照组采用"放射状多切口挂线引流"术式。比较2组手术时间、术后疼痛时间、创面愈合时间、肛门瘢痕大小、肛门畸形、肛门功能状况以及术后复发情况。结果观察组比对照组手术时间短(P<0.01)、术后疼痛持续时间短(P<0.01)、创面愈合时间短(P<0.01)、肛门瘢痕小(P<0.01)、肛门畸形发生率低(P<0.01)、肛门部分失禁发生率低(P<0.01),但术后复发率2者差异无统计学意义(P>0.05)。结论切开双挂线引流手术治疗高位后蹄铁型肛周脓肿的效果比放射状多切口挂线引流术好。

Objective To explore the more reliable and effective operation for the high posterior perianal abscess of horse shoe shape.Methods Sixty cases with high posterior perianal abscess of horse shoe shape were randomly divided into two groups-an observing group and a control group,either group having 30 cases.Incision and double thread-drawing drainage was used in the observing group while hanging line drainage by multiple incisions of radian shape was used in the control group.The operation time,pain lasting time,healing time of incision,area of anal scar,anal malformation and function,and postoperative recurrence were observed and compared between the two groups.Results Compared with those of the control group,all the operative time,postoperative pain lasting time,and healing time of incision were shortened（P0.01）,and the incidence of anal malformation（P0.01） and partial anal incontinence（P0.01） were lower in the observing group.There was no significant difference in postoperative recurrence between the two groups. Conclusions The operation through incision and double thread-drawing drainage is superior to hanging line drainage by multiple incisions of radian shape on the management of high posterior perianal abscess of horse shoe shape.