瘘管剔除后侧面切口缝合治疗蹄铁型肛瘘的疗效观察

Suture of Lateral Incision after Removal of Fistula Tract for Horseshoe-shaped Anal Fistula： Observation on Curative Effect

为观察瘘管完全剔除，侧面切口缝合、后正中切口作切开延长治疗蹄铁型肛瘘的临床疗效，将60例蹄铁型或半蹄铁型肛瘘患者随机分为两组，对照组30例，将蹄铁型或半蹄铁型肛瘘的瘘管完全剔除，处理内口后，侧面与后正中切口完全敞开；治疗组30例，同样剔除肛瘘瘘管，处理内口后，将侧面切口缝合，后正中切口延长。观察两组术后创口疼痛、创口愈合情况及创口愈合时间等指标。结果显示，治疗组在术后创口疼痛、创口愈合时间方面明显优于对照组（P〈O．05）。两组创口愈合情况无明显差异。结果表明，蹄铁型或半蹄铁型肛瘘在完全剔除瘘管，处理内口后，侧面切口缝合、后正中切口延长的手术方法痛苦小，愈合时间短，疗效明显。

This study was to observe the clinical efficacy of horseshoe-shaped anal fistula treated by a sur- gical procedure that the lateral incision was sutured and posterior midline incision extended after complete removal of the fistula tract. Sixty patients with horseshoe-shaped or semi-horseshoe anal fistula were ran- domly divided into two groups,30 patients for each. Both groups were treated in the same way that the fis- tula tract was removed completely,but then in control group,after the internal opening was managed,mak- ing lateral and posterior midline incisions completely open;while in treatment group,after the lateral inci- sions got suture,making posterior midline incisions being extended. Both groups were observed for pain, healing and healing time of the wounds. The results showed that treatment group was superior to control group in wound pain,and wound healing time（ P d0.05） ,and there was no significant difference between two groups in wound healing outcome. It is concluded that the lateral incision gets suture and posterior midline incision is extended after complete removal the tract of horseshoe or semi-horseshoe-shaped fistula and management of internal opening is of less pain,shorter healing time and obvious efficacy.