对口切剥结合早期垫棉法治疗复杂性肛瘘临床观察

Clinical observation of the contra-aperture dissection and early cotton pad drainage therapy in treating complex anal fistula

目的观察对口切剥结合早期垫棉法治疗复杂性肛瘘的临床疗效。方法将90例复杂性肛瘘患者随机分为三组,每组30例。早期垫棉组和常规垫棉组采用对口切剥术,对照组采用传统的复杂性肛瘘切除术,分别观察三组治愈率、治愈时间、复发率、肛门功能等情况。结果三组治愈率相比无显著性差异(P>0.05);三组治愈时间有显著性差异,早期垫棉组时间明显缩短(P<0.01);痊愈时Wexner评分三组有显著性差异(P<0.01),早期垫棉组、常规垫棉组明显优于对照组(P<0.01);6个月随访时三组无统计学差异(P>0.05)。结论对口切剥结合早期垫棉法治疗复杂性肛瘘,可明显缩短治愈时间,较好的保护肛门功能。

Objective To observe the clinical efficacy of the contra-aperture dissection and early cotton pad drainage therapy in treating complex anal fistula. Methods Ninety subjects were randomized divided into three groups： early cotton pad drainage therapy group and routine cotton pad drainage therapy group in which 30 cases each were treated with contra-aperture dissection, and control group in which 30 cases were treated by anal fistulot- omy. The clinical efficacy including recovery rate, healing time, recurrence rate and anal function were observed in apy group was the shortest （ P 〈 0. 01 ）. The Wexner scores were of significant after recover （ P 〈 0. 01 ） , and the early cotton pad drainage therapy group and routine cotton pad drainage therapy group were of significantly better than the control group. Six months later the Wexner scores were of no significant difference among three groups （ P 〉 0. 05 ）. Conclusion The therapy of contra-aperture dissection and early cotton pad drainage can reduce wound- healing time and protect anal functions in the treating of complex anal fistula.