改良经括约肌间瘘管结扎术-Plug术治疗低位肛瘘的可行性研究

Feasibility study of modified intersphincteric fistula ligation-Plug surgery in the treatment of low anal fistula

目的 探讨改良经括约肌间瘘管结扎术-Plug术治疗低位肛瘘的可行性。方法 选取2013年11月~2015年9月在本院接受治疗的120例低位肛瘘患者作为研究对象,根据治疗方案不同,分为研究组和对照组。对照组采用肛瘘切除术进行治疗,研究组采用改良经括约肌间瘘管结扎术-Plug术进行治疗。比较两组的手术相关项指标及术后恢复情况、VAS评分、临床疗效、术后并发症发生率。结果 研究组的瘢痕面积显著小于对照组,愈合时间、住院时间显著短于对照组,尿潴留发生率显著低于对照组,差异有统计学意义（P〈0.05）。研究组术后12 h、首次排便及首次换药的VAS评分显著低于对照组,差异有统计学意义（P〈0.05）。研究组的总有效率显著高于对照组,差异有统计学意义（P〈0.05）。研究组的并发症发生率显著低于对照组,差异有统计学意义（P〈0.05）。结论 改良经括约肌间瘘管结扎术-Plug术治疗低位肛瘘效果显著,安全可行,临床总有效率高,术后并发症发生率低,值得临床推广应用。

Objective To explore the feasibility of modified ligation of the intersphincteric fistula tract-Plug surgery in the treatment of low anal fistula. Methods 120 patients with low anal fistula from November 2013 to September 2015 in our hospital were selected and divided into the research group and the control group according to different therapeu- tic regimen.The control group was treated with anal fistulectomy,the research group was treated with modified ligation of the intersphincteric fistula tract＇Plug surgery.The surgical related indexes and postoperative recovery condition,the score of visual analogue scale （VAS）,clinical effect,the incidence of postoperative complication in the two groups was compared. Results The scar area in the research group was less than that in the control group,healing time,hospital stay in the research group was shorter than that in the control group,the incidence of urinary retention in the research group was lower than that in the control group,with significant difference （P〈0.05）.The VAS score of 12 hours after surgery,in the first defecation and in the first dressing change in the research group was lower than that in the control group,with significant difference （P〈0.05）.The total effective rate in the research group was higher than that in the control group, with significant difference （P〈0.05）.The incidence rate of complication in the research group was lower than that in the control group,with significant difference （P〈0.05）. Conclusion Modified ligation of the intersphincteric fistula tract- Plug surgery can obtain a remarkable effect in the treatment of low anal fistula,which is safe and feasible at advantages of a high total clinical effective rate and low incidence of postoperative complications,it is worthy of clinical promotion and application.