旷置拖线法治疗高位复杂性肛瘘48例临床观察

Thread-dragging Plus Exclusion for High Complex Anal Fistula：Clinical Observation of 48 Cases

为评价旷置拖线法治疗高位复杂性肛瘘的临床疗效及安全性，将96例高位复杂性肛瘘患者随机分为治疗组和对照组，治疗组48例采用旷置拖线法治疗，对照组48例采用切开挂线法治疗，观察两组治愈率、治愈时间，记录术后第2、7、14天的疼痛评分，随访术后6个月肛门功能。结果显示，两组一次性治愈率分别为91．7％与89．6％（P〉0．05）；平均治愈时间分别为（36．9±13．2）d和（46．3±12．8）d（P〈0．01）；术后第2、7、14天疼痛评分，两组比较有显著性差异；术后随访6个月，两组肛门功能无显著性差异。结果表明，旷置拖线法治疗高位复杂性肛瘘能缩短疗程，减少术后疼痛，较好地保护肛门括约肌及肛周组织的完整性。

This study was to evaluate the clinical efficacy and safety of thread-dragging plus exclusion for high complex anal fistula,96 cases of high complex anal fistula were randomly divided into treatment group and control group,48 cases for each group. The former received thread-dragging plus exclusion,while the latter underwent incision and thread-drawing.Both groups were observed for curative rate, healing time,and recorded for pain scores on the d 2,d 7 and d 14 after operation,and the anal function after a 6-month follow-up.The results showed that the curative rate after one-off operation was 91.7% and 89.6% ,respectively each group（ P〉0.05）; the average healing time was （36.9±13.2）d and（46.3±12.8）d（ P 〈0.01）,re spectively; significant difference was found between two groups in the pain scores on the d 2,d 7 and d 14 after operation; no significant difference was found between two groups in anal function after a 6-month follow-up.h is concluded that thread-dragging plus exclusion for high complex anal fistula can shorten the treatment course,reduce postoperative pain of patients and protect the integrity of anal sphincter and peri- anal tissue.