高位虚挂线法与实挂线法治疗高位肛瘘的临床对比研究

High Loosing Thread-drawing Versus Conventional Thread-drawing for High Anal Fistula

为探讨高位虚挂线法治疗高位肛瘘在肛门功能保护及术后并发症方面的优势，将高位肛瘘80例患者随机分为治疗组和对照组，每组40例。术中分别以实挂线法和虚挂线法治疗，比较两组术后创面愈合时间、肛管静息压及最大收缩压的变化、术后肛管锁眼畸形、肛门漏气漏液、复发情况。结果显示，术后治疗组创面愈合时间较对照组短（P〈0．05），肛管锁眼畸形发生率较对照组低（P〈0．05）；肛管静息压和最大收缩压方面，治疗组术后无明显变化（P〉0．05），对照组术后较术前降低（P〈0．05）；治疗组未见术后肛门漏气漏液，对照组为20例（P〈0．05）；两组各有1例复发。结果表明，高位虚挂线法治疗高位肛瘘在创面愈合时间、术后并发症及减轻患者疼痛方面优于传统的实挂线法。

This study was to discuss the advantages of high loosing thread-drawing in protecting anal tunc- tion and postoperative complications in treating high anal fistula. The 80 cases of high anal fistula were ran- domized into treatment group and control group, 40 cases for each. Control group received conventional thread-drawingwhile treatment group underwent high loosing thread-drawing. Both groups were compared for postoperative wound surface healing time, anal resting pressure and anal maximum systolic pressure, keyhole deformity and humor ~ air leakage of anus, and recurrence. The results showed that wound surface healing time was shorter in treatment group than in control group（ P 〈0.05） ,the incidence of anal keyhole deformity was lower in treatment group than in control group（ P 〈0.05）. Anal resting pressure and anal maximum systolic pressure in treatment group showed no significant change after treatment （ P〈0.05）, but they were lowered than before surgery in control group（ P〈0.05）. There was no case of anal humor air leakage in treatment group, but 20 cases in the controls. Each group had one case of recurrence. It is concluded that high loosing thread-drawing is superior to conventional thread-drawing in wound surface healing time, reducing postoperative complications and pain.