低位挂线高位扩创引流术治疗高位复杂性肛瘘随机对照临床研究

Clinical Observation of Low Seton and High Opening-drainage Therapy for High Complex Anal Fistula: A Randomized Controlled Trial

目的:观察低位挂线高位扩创引流术治疗高位复杂性肛瘘的临床疗效。方法:将90例高位复杂性肛瘘患者随机分为治疗组和对照组,每组45例。治疗组采用低位挂线高位扩创引流术,对照组采用低位切开高位挂线术。观察两组患者的治愈时间、治愈率、随访3个月后的复发情况,评价两组患者的肛门功能。结果:治疗组患者的治愈时间较对照组明显缩短(P<0.01);两组患者的治愈率及复发情况比较,其差异无统计学意义(P>0.05)。出院时及随访3个月后,两组患者的直肠静息压、肛管最长收缩时间比较,其差异无统计学意义(P>0.05);治疗组患者的肛管静息压、肛管最大收缩压较对照组明显升高(P<0.05)。结论:低位挂线高位扩创引流术治疗高位复杂性肛瘘可缩短治愈时间,较好地保护肛门功能。

Objective： To evaluate the effects of low seton and high opening-drainage therapy in treating high complex anal fistula.Methods： Ninety subjects with high complex anal fistula were randomly divided into two groups： treatment group in which 45 cases were treated with low seton and high opening-drainage therapy and control group in which 45 cases were treated with low incision and high seton therapy.The cure time,cure rate,and recurrence were observed,and the function of anal sphincter was evaluated.Results： The cure time of treatment group was shorter than that of control group（P0.01）;the cure rate and recurrence were of no significant difference between two groups（P0.05）.While hospital discharge and after three months follow-up,the rectal rest pressure and anal longest contraction time were of no significant difference between two groups（P0.05）;the anal rest pressure and anal maximal contraction pressure of treatment group were higher than those of control group（P0.05）.Conclusion： Low seton and high opening-drainage therapy has good effects on high complex anal fistula with shorter treatment course,and can protect the function of anal sphincter.