改良式脱细胞真皮基质内口缝合外口引流修复新疆维吾尔族高位复杂性肛瘘

Modified acellular dermal matrix repair combined with opening suture and drainage in the treatment of Uygur high complex anal fistula in Xinjiang

背景:目前国内外高位复杂性肛瘘手术方法都存在一定的复发率和肛门功能障碍等一系列问题。目的:分析改良式脱细胞真皮基质内口缝合外口引流修复新疆维吾尔族高位复杂性肛瘘的临床效果。方法:选择维吾尔族连续性高位复杂性肛瘘患者40例,以区组随机分组方法分成试验组和对照组。试验组采用改良式脱细胞真皮基质内口缝合外口引流修复治疗,对照组采用切开挂线引流修复治疗。结果与结论:两组术后瘘管闭合时间、治愈率及疼痛程度差异无显著性意义(P>0.05),试验组疼痛持续时间、住院时间及生活质量改善评分方面显著优于对照组(P<0.05)。表明改良式脱细胞真皮基质内口缝合外口引流修复可促使高位复杂性肛瘘的愈合,可以明显缩短高位复杂性肛瘘术后疼痛时间与住院时间,但结果缺乏多中心随机大样本临床对照试验的验证。

BACKGROUND：Surgical methods for high complex anal fistula have certain recurrence rate and a series of problems such as anal dysfunction in the world.OBJECTIVE：To discuss the clinical application of modified acellular dermal matrix repair combined with opening suture and drainage technique for the treatment of Uygur high complex anal fistula in Xinjiang.METHODS：Forty cases of Uygur high complex anal fistula in Xinjiang were selected.All the cases were randomly divided into experimental group and control group.Cases in the experimental group were treated using modified acellular dermal matrix repair combined with opening suture and drainage technique,and the cases in the control group were treated with traditional drainage.RESULTS AND CONCLUSION：There was no significant difference in the aspect of fistula closure time,recover rate and postoperative pain score between two groups（P 〉 0.05）.However,the aspect of postoperative pain time,hospitalization time and life quality scores in the experimental group were significantly better than those in the control group（P 〈 0.05）.Modified acellular dermal matrix repair combined with opening suture and drainage has a certain effect on the healing of high complex anal fistula.However,the safety and efficacy of this method needs further multi-center and randomized controlled clinical trials to verify.