隧道式拖线术与多切口切开引流术治疗低位蹄铁型肛周脓肿的随机对照研究

Randomized controlled study of tunnel thread surgery and multi-incision incision and drainage in treatment of low horseshoe-shaped perianal abscess

目的研究隧道式拖线术与多切口切开引流术治疗低位蹄铁型肛周脓肿的随机对照临床试验。方法选取2011年12月~2012年12月我院收治的低位蹄铁型肛周脓肿患者130例,按照随机数字表法将患者分为A组和B组,每组65例,A组予隧道式拖线术治疗,B组予多切口切开引流术治疗,术后随访2年,比较两组临床疗效、疼痛情况、愈合时间、瘢痕面积、肛门功能以及复发。结果两组总有效率比较无统计学意义（P〉0.05）;A组疼痛持续时间显著短于B组,两组比较差异具有统计学意义（P〈0.05）;A组愈合时间显著短于B组,A组瘢痕面积显著小于B组,两组比较差异具有统计学意义（P〈0.05）;随访发现,两组均无肛门狭窄、失禁和畸形等后遗症,A组复发2例,B组复发3例,均经再次手术治愈,两组复发率比较差异无统计学意义（P〉0.05）。结论隧道式拖线术治疗低位蹄铁型肛周脓肿能减轻术后疼痛,减少瘢痕面积,有利于术后愈合。

Objective To study the randomized controlled study of tunnel thread surgery and multi-incision incision and drainage in treatment of low horseshoe-shaped perianal abscess. Methods All 130 cases with low horseshoe-shaped perianal abscess were selected from our hospital during the period from December 2011 to December 2012, the patients were divided into group A and group B according to random number table, 65 cases in each group, the group A was given tunnel thread surgery, the group B was given multi-incision incision and drainage, patients were followed up for 2 years, clinical efficacy, pain, the healing time, the scar area, anal function and recurrence of two groups were compared. Results Total efficiency of two groups were no significant（P〉0.05）;Duration of pain of the group A were significantly shorter than group B, the difference was statistically significant（P〈0.05）;Healing time of the group A were significantly shorter than group B,scar areaof the group A were significantly smaller than group B,the difference was statistically significant（P〈0.05）;follow-up found,there were no anal stenosis,incontinence and other complications and deformities in both groups,two cases of recurrence in group A,3 cases of recurrence in group B,they were cured by reoperation,the difference of two recurrence had no statistical significance（P〉0.05）. Conclusion Tunnel thread surgery in treatment of low horseshoe-shaped perianal abscess can reduce postoperative pain and reduce scar area,conducive to healing after surgery.