多窗口截管分段引流法治疗高位复杂性肛瘘临床观察

Clinical observation of multi-windows tube-cutting and piecewise method for high complex anal fistula

目的比较多窗口截管分段引流法与常规对口引流法治疗高位复杂性肛瘘的临床疗效。方法将73例高位复杂性肛瘘患者随机分为治疗组(36例)和对照组(37例),分别采用多窗口截管分段引流和常规对口引流治疗;术后随访创面愈合时间以及再次扩创、复发、肛门功能情况。结果治疗组36例均一次手术治愈,对照组一次手术治愈32例,未愈的5例经再次扩创后治愈;两组均无复发病例。两组创面愈合时间及再次扩创情况比较,差异有统计学意义(P<0.05)。两组肛管最大收缩压、肛管舒张压比较,差异均无统计学意义(P>0.05)。结论多窗口截管分段引流法可明显缩短创面愈合时间,降低再次扩创几率。

Objective To compare the clinical efficacy of multi-windows tube-cutting and piecewise method with conventional aboral drainage method in the treatment of high complex anal fistula. Methods Seventy-three cases were randomized into two groups： treatment group in which 36 cases were treated by tube-cutting and pieeewise method, and control group in which 37 cases were treated by conventional aboral drainage method. Follow-up visit to the wound healing time, anal function after debridement and relapse were detected. Results Thirty-six cases in treatment group were cured, and 32 cases in control group were cured after operation. Five cases in control group were cured after debridement again ; no relapse was found in the two groups. There were significant differences in wound healing time and debridement between the two groups （P 〈 0.05 ）. There was no significant difference in maximum systolic pressure and diastolic pressure of anal tube in the two groups （ P 〉 0.05）. Conclusion Multi-windows tube-cutting and piecewise method can shorten the wound healing time and reduce the probability of debridement.