LIFT与切开挂线术治疗复杂性肛瘘的疗效评价

Efficacy evaluation of LIFT and incision-thread-drawing procedure in the treatment of complex anal fistula

目的探究复杂性肛瘘应用括约肌间瘘管结扎术(LIFT)与切开挂线术的治疗效果。方法 65例复杂性肛瘘患者,采用随机信封法分为对照组(32例)和试验组(33例)。对照组患者应用切开挂线术治疗,试验组患者应用LIFT治疗。分析比较两组患者的手术指标、创伤愈合时间及并发症发生情况。结果试验组患者的出血量(29.4±3.5)ml、创面面积(2.9±0.8)cm^2、疼痛时间(3.0±0.8)d、创伤愈合时间(10.7±3.5)d均低于对照组的(37.3±3.5)ml、(7.0±0.7)cm^2、(7.7±1.0)d、(13.0±3.1)d,差异具有统计学意义(P<0.05)。试验组并发症发生率为9.1%(3/33),对照组并发症发生率为40.6%(13/32);两组患者的并发症发生率比较差异具有统计学意义(P<0.05)。结论复杂性肛瘘应用LIFT与切开挂线术均具有一定的治疗效果,但前者手术指标、创伤愈合时间、并发症发生率均优于后者,临床应用价值较高,值得推广。

Objective To discuss the treatment effect of ligation of the intersphincteric fistula tract(LIFT) and incision-thread-drawing procedure in the treatment of complex anal fistula. Methods A total of 65 complex anal fistula patients were divided by random envelope method into control group(32 cases) and experimental group(33 cases). The control group was treated with incision-thread-drawing procedure, and the experimental group was treated with LIFT. Analysis were made on surgical indicators, wound healing time and occurrence of complications between the two groups. Results The experimental group had bleeding volume as(29.4±3.5) ml, wound area as(2.9±0.8) cm^2, pain time as(3.0±0.8) d and wound healing time as(10.7±3.5) d, which were all lower than(37.3±3.5) ml,(7.0±0.7) cm^2,(7.7±1.0) d and(13.0±3.1) d in the control group, and their difference was statistically significant(P<0.05). The experimental group had incidence of complications as 9.1%(3/33), which was 40.6%(13/32) in the control group. Both groups had statistically significant difference in incidence of complications(P<0.05). Conclusion Both LIFT and incision-thread-drawing procedure are effective in treating complex anal fistula, but the former is superior to the latter in terms of operation index, wound healing time and complication rate. It has high clinical value and is worth popularizing.