一次性切开挂线根治术治疗肛周脓肿的临床研究

Clinical research into disposable incision seton radical resection to treat perianal abscess

目的基于索罗门定律,探究一次性切开挂线根治术治疗肛周脓肿的疗效及理论依据。方法选取2013-06—2015-12于沈阳市肛肠医院和辽宁省肛肠医院前来就诊的肛周脓肿患者154例进行临床研究,所有患者治疗措施基于索罗门定律的指导,采用一次性切开挂线根治术,术后进行中药熏洗、中医紧线、消毒换药等相关对症治疗,治疗后观察患者临床疗效及创口愈合时间、感染例数、畸形或功能障碍例数,并对所有患者进行3个月随访,观察术后肛门功能恢复情况及相关不良反应。结果治疗肛周脓肿154例,治愈151例,好转3例,未愈0例。1例患者因术后未能及时就诊进行术后换药,形成创面假愈合情况,采用二次切开手术后痊愈。一次治愈率为99.35%,总有效率为100%,创口愈合时间为(17.29±1.35)d,发生感染2例,出现假创面1例,无其他相关不良反应时间发生,术后随访无肛瘘及其他肛门功能障碍及相关并发症发生。结论通过运用索罗门定律指导一次性切开挂线术,能够达到准确找出肛周脓肿内口的目的,提高一次性切开挂线术治疗的成功率,减少了其他术后不良反应的发生率,一次性切开挂线术值得临床进行推广应用,索罗门定律的拓展研究亦值得进行深入研究。

Objective To explore the curative effect and the theoretical basis of disposable incision seton radical re- section to treat perianal abscess based on Salmon＇s Law.Methods 154 cases with perianal abscess coming for treat- ment to Shenyang Anorectal Hospital and Liaoning Provincial Anorectal Hospital from June 2013 to December 2015 were selected for the clinical research.The therapeutic measures for all sufferers were based on the guidance of Salmon＇s Law, and disposable incision seton radical resection was adopted.The related symptomatic treatment of Chi- nese herbal fumigation and washing, traditional Chinese medicine stringing, and disinfection for dressing change were conducted after surgery.The clinical effect, surgical incision healing time, infection case number, malformation or dys- function case number of the sufferers were observed, and a 3-month follow-up visit was conducted for al sufferers, so as to observe the anal fimction recovery and related adverse reactions. Results Among 154 cases with perianal ab- scess, 151 cases were cured, 3 cases got improved, and 0 case ineffective. 1 case showed fake healing status with post- operative failure to timely dressing change, but got cured after the second surgical operation.The one-time cure rate was 99.35%.The total effective rate was 100% ;The surgical incision healing time was（17.29 ＋ 1.35）days ;There were 2 cases with infections and 1 case with fake healing, but no other related adverse reactions.Postoperative follow-up vis- its found no anal fistula or anal dysfunction or related complications.Conclusion Disposable incision seton radical re- section under the guidance of Salmon＇s Law can accurately identify the internal opening of perianal abscess, increase the success rate of disposable incision seton radical resection, and reduce the incidence of postoperative adverse reac- tions.Disposable incision seton radical resection is into Salmon＇s Law is also worth in-depth study.