低位切开高位虚挂线术治疗高位肛瘘临床观察

Clinical Study of Inferior Incision Combined with Loose thread-drawing operation in the treatment of high anal fistula

目的探讨低位切开高位虚挂线术治疗高位肛瘘临床疗效。方法将27例高位肛瘘患者随机分为两组,其中治疗组13例,采用低位切开高位虚挂术;对照组14例,采用低位切开高位实挂术。两组术后作对比观察。结果治疗组与对照组治愈率分别为92.3%和92.9%,差异无统计学意义(P>0.05),但治疗组和对照组在术后疼痛,术后及术后3个月肛门功能评价,并发症(漏气、锁眼畸形)等,差异均有统计学意义(P<0.05)。结论虚挂线术和实挂线术治疗高位肛瘘治愈率,差异无统计学意义,但虚挂线术较实挂线术能更好的保护肛门括约肌功能,减少肛门失禁的发生。

Objective To observe the clinical effect of Inferior Incision Combined with Loose thread-draw- ing operation on high anal fistula. Methods Twenty seven cases of high anal fistula were randomly divided into two groups. Forteen cases in the treatment group were treated with Inferior Incision Combined with Loose thread-drawing operation. The other Thirteen cases in control group were treated with Inferior Inci- sion Combined with Tight thread-drawing operation. Results the curetive rate was 92.3% in the test group and 92.8% in the control group;there was no significant difference in the total response rate between the two groups （ P 〉0.05）. There was significant difference in postoperative pain, healing time and anal func- tion between the two groups （ P 〈0.05）,but had notable difference in Post-operative pain,Postoperative and 3m postoperativ anus function appraisal and in postoperation complications {leakage of gas, key-hole deformation） （ P 〈0.05 ）. Conclusion The difference of curative rate in 2 groups has no statistical signifi- cengce , but compared with traditional tight thread-drawing, loose thread-drawing can protect the anaus form and function better, and reduce the occurrence of anal incontinence. The Inferior Incision Combined with Loose thread-drawing operation is an effective and safe procedure for high anal fistul.