改良经括约肌间瘘管结扎术-Plug术治疗低位肛瘘的临床效果观察

Ligation of intersphincteric fistula tract plus bioprosthetic anal fistula plug in treatment of low anal fistula

目的通过试验对比，探究改良经括约肌间瘘管结扎术-Plug术（LIFT-Plug术）的临床疗效。方法选取128例低位肛瘘的患者，分别行括约肌间瘘管结扎术和常规瘘管切除术，对比两组患者的临床疗效。结果两组患者的手术时间、复发的概率比较，P〉0．05，差异无统计学意义。试验组患者的术后愈合时间明显短于对照组患者，遗留的瘢痕面积明显小于对照组患者，尿潴留的发生率也明显低于对照组患者，P〈0．05，差异均有统计学意义。试验组中患者疗效显著的概率明显高于对照组，P〈0．05，差异均有统计学意义。试验组和对照组手术的总有效率比较，P〉0．05，差异无统计学意义。结论改良经括约肌间瘘管结扎术与常规瘘管切除术的临床疗效差异无有统计学意义，并且具有愈合时间短、尿潴留等并发症的发生率低等优点，建议临床推广使用LIFT-Plug术治疗低位肛瘘。

Objective To explore the clinical efficacy of ligation of intersphincteric fistula tract plus bioprosthetic anal fistula plug （LIFT-plug）. Methods 128 patients with low anal fistula were selected and were performed LIFT-plug or general fistula surgery. The clinical efficacies were compared between the two groups. Results There were no statistical differences in operation time and the probability of relapse between the two groups （P〉 0.05）. After the operation, the healing time was significantly shorter, the remained scar area was significantly smaller, the incidence of urinary retention was significantly lower, and the effect was significantly better in the experimental group than in the control group, with statistical differences （P〉0.05）. There was no statistical difference in total efficacy between the two groups （P〉 0.05）. Conclusions LIFT-plug has no statistical difference in clinical efficacy from direct fistula resection; the healing time is short; the incidence of complications, such as urinary retention, is low, and so on. LIFT-plug for low anal fistula should be clinically generalized.