改良挂线对口引流术治疗复杂性肛瘘合并脓肿的临床疗效

Improved Thread-drawing and Contradrainage for Complex Anal Fistula Complicated with Abscess

为评价改良挂线对口引流术与传统切开挂线术治疗复杂性肛瘘合并脓肿的临床疗效，将100例复杂性肛瘘合并脓肿患者随机分为改良挂线对口引流术组（治疗组）50例和传统切开挂线术组（对照组）50例，观察比较评价两组术后疗效及手术前后肛肠动力学检测结果。结果显示，两组患者均近期治愈，治疗组患者术后在住院时间、创面愈合时间、复发情况及住院费用方面优于对照组（P〈0．05）。两组术后随访1～3年，无肛门失禁、肛门狭窄及肛门畸形等。肛肠动力学检测：治疗组手术前后肛管、直肠压力无显著性差异，对照组手术后肛管、直肠压力显著低于手术前（P〈0．05）。结果表明，改良挂线对口引流术治疗复杂性肛瘘合并脓肿手术一次成功，降低了复发率，减少了并发症，保护了肛门括约肌的功能及肛周皮肤的完整性，患者痛苦小，疗程短。

To evaluate the efficacy of improved thread-drawing and contradrainage and conventional threaddrawing and incision for complex anal fistula complicated with abscess, 100 cases were randomly divided in- to treatment group （improved thread-drawing and contradrainage）and control group（conventional threaddrawing and incision）,50 cases for each group.Clinical efficacy and the results of anorectal dynamics were compared and evaluated. The results showed that both groups obtained short-term cure, treatment group was superior to control group in hospital stay,wound healing time,recurrence and medical costs（ P〈 0.05）.both groups had no anal incontinence, anal stenosis, anal malformation after a 1-3 year follow-up.The results of anorectal dynamics.anorectal pressure showed no significant difference in treatment group, but decreased significantly after surgery in control group （ P 〈0.05）. It is concluded that improved threaddrawing and contradrainage can primary successfully treat complex anal fistula complicated with abscess, reduce recurrence rate and complications,protect the function of anal sphincter and the integrity of perianal skin,with less pain and shorter course of treatment.