一期根治术与单纯切开引流术治疗肛周脓肿的疗效对比观察

Primary Radical Procedure and Simple Incision ＆ Drainage for Perianal Abscess：Comparative Observation on Therapeutic Effect

为比较一期根治术与单纯切开引流术治疗肛周脓肿的临床疗效，回顾2010年5月至2012年7月于我院行一期根治术或单纯切开引流术治疗的162例肛周脓肿患者资料，其中行一期根治术治疗106例（观察组），行单纯切开引流术治疗56例（对照组），并对两种术式的治疗效果进行对比分析。结果显示，术后随访1～2年，观察组治愈101例（95．28％），发生肛瘘5例（4．72％）；对照组治愈19例（33．93％），发生肛瘘37例（66．07％）。观察组肛瘘发生率明显低于对照组，差异有显著统计学意义，P＜O．01。术后随访和二次手术术中探查发现，观察组术后发生肛瘘主要是由于内口定位不准确所致。结果表明，一期根治术治疗肛周脓肿对防止术后形成肛瘘有较明显的效果，对内口定位清楚的肛周脓肿患者采用一期根治术是比较理想的选择。

In order to compare the clinical effects of primary radical procedure with simple incision drain- age for perianal abscess, authors retrospectively analyzed the data of 162 patients with perianal abscess who received surgery in author＇s hospital from May 2010 yr. to July 2012 yr. ,among them 106 cases had been subjected to primary radical procedure（as observation group）,56 to simple incision ga drainage（as control group） ,and compared and analyzed their curative outcome. As results, the postoperative follow-up of 1-2 yr. found that in observation group 101 cases（95.28） were cured,5（4.72%） had anal fistula,while in control group,19（33.93o/oo） ,37（66.07） ,respectively;as to incidence of anal fistula observation group was significantly lower than control group, there was significant statistical difference（ P d0.01） ;the postoper- ative follow-up and secondary operative exploration found that the cause of anal fistula was mainly uncor- rect location of internal opening. Results show that primary radical procedure for perianal abscess had more significant efficacy on prevention of postoperative anal fistula formation,if the internal opening of perianal abscess patients had been located then they should receive primary radical procedure.