改道置管引流术治疗直肠黏膜下脓肿45例

Treatment of rectal submucosal abscess by redirection catheter drainage therapy: report of 45 cases

目的探讨改道置管引流术治疗直肠黏膜下脓肿的临床疗效。方法将90例直肠黏膜下脓肿患者随机分为治疗组和对照组,每组45例;治疗组予改道置管引流术,对照组予传统切开引流术;观察两组患者治愈率、治愈时间及术后疼痛情况、复发情况,并评价肛门功能。结果治疗组、对照组的治愈率分别为97.3%和68.9%,治疗组治愈率高于对照组(P<0.01),治愈时间少于对照组(P<0.01)。治疗组术后48 h、7天、14天换药时局部疼痛评分均少于对照组(P<0.01)。两组术后3个月比较,肛门功能差异无统计学意义(P>0.05);治疗组、对照组疾病复发率分别为2.3%、32.3%,治疗组明显低于对照组(P<0.01)。结论改道置管引流术治疗直肠黏膜下脓肿可缩短疗程,提高治愈率,减轻术后疼痛,降低复发率。

Objective To observe the clinical efficacy of redirection catheter drainage therapy for the treatment of rectal submucosal abscess. Methods Ninety cases were randomized into two groups： treatment group in which 45 cases were treated by redirection catheter drainage therapy, and control group in which 45 cases were treated by incision and drainage therapy. The cure rate, cure time, pain and recurrence were observed and the anal function was evaluated. Results The cure rate was 97.3% in the treatment group and 68.9% in the control group,, and the cure rate in treatment group was higher than that of the control （P 〈 0.01 ）, while the cure time was less than that of the controls （P 〈 0.01 ）. In treatment group, the pain score at 48 h, 7d, 14d after operation were less than that of the controls （P 〈 0.01 ）. After 3 months of operation, no significant was found in anal functions between the two groups （P 〉 0.05 ）. The recurrence rate was 2.3% in the treatment group and 32.3% in the control group, with significant difference between the two groups （ P 〈 0.01 ）. Conclusion The redirection catheter drainage therapy can shorten the course of treatment, improve the cure rate, lessen postoperative pain and reduce the recurrence rate.