对口切开旷置结合垫棉法治疗高位复杂性肛瘘的疗效评价

Clinical analysis of counter-incision exclusion with cotton pad in treating high complex anal fistula

目的评价对口切开旷置结合垫棉法治疗高位复杂性肛瘘的临床疗效及安全性。方法将60例高位复杂性肛瘘患者随机分为两组;治疗组30例采用对口切开旷置结合垫棉法,对照组30例采用切开挂线法;记录术后当天、术后第2、7、14天的疼痛、渗液和发热情况并予评分;同时进行肛门压力检测。结果治疗组术后疼痛、发热、渗液的改善优于对照组(P<0.01);治疗组创面平均治愈天数少于对照组(P<0.01);两组术后随访直肠静息压和肛管静息压,组间比较有显著性差异(P<0.01)。结论对口切开旷置结合垫棉法治疗高位复杂性肛瘘能减少术后并发症,缩短疗程,较好地保护肛门功能。

Objective To evaluate the curative effects of counter-incision exclusion with cotton pad in the treatment of high complex anal fistula.Methods Sixty subjects were randomized into two groups： treatment group in which 30 cases were treated by counter-incision exclusion with cotton pad,and control group in which 30 cases were treated by incision and thread drawing.On the first,second,seventh and fourteenth days after operation,the postoperative pain,exudate and fever were recorded and scored.Anorectal dynamic changes were compared simultaneously.Results The scores of pain,exudate and fever were improved more significantly in the treatment group than in the control group（P0.01）;the wound-healing time was shorter in the treatment group than in the control group（P0.01）;there were significant differences in the rectal resting pressure and anal resting pressure between the two groups（P0.01）.Conclusion Counter-incision exclusion with cotton pad can reduce postoperative sequelae,shorten wound-healing time and protect anal functions in the treatment of high complex anal fistula.