经括约肌间瘘管结扎术与单纯切开挂线术治疗复杂性肛瘘的临床观察

Clinical observation of comparing the effect of ligation of inter sphincteric stula tract and incision-thread-drawing procedurein treatment of the complex anal fistulas

目的比较经括约肌间瘘管结扎术(LIFT)及单纯切开挂线术治疗复杂性肛瘘的临床疗效。方法选取2013年1月至2015年6月于本院就诊的60例复杂性肛瘘患者为研究对象,随机分为观察组和对照组,每组各30例。观察组予LIFT治疗,对照组予单纯切开挂线术治疗。比较两组手术相关情况、创面愈合时间、治疗有效率及治疗前后肛门功能情况(随访至术后6个月)。结果观察组患者手术时间较对照组明显延长(P<0.05),观察组术中出血量、术后创面面积、术后疼痛持续时间、住院时间、创面愈合时间及术后Wexner肛门失禁评分均少于对照组,差异均有统计学意义(P<0.05)。观察组治疗有效率为86.67%,对照组有效率为90.00%,差异无统计学意义(P>0.05)。结论与单纯切开挂线术相比,经括约肌间瘘管结扎术治疗复杂性肛瘘总体疗效更优,利于保留肛门括约肌自控功能。

Objective To observe the effect of ligation of inter sphincteric stula tract in treatment of patients with the complex anal fistulas.Methods 60 patients with complex anal fistulas were randomly divided into two groups,30 persons in every group,observation group treated with ligation of inter sphincteric stula tract,control group treated with incision-thread-drawing procedure.The cure rate,operative time,hospital stay,blood loss,duration of postoperative pain,wound healing time and anal function score were recorded.（Both of the two groups were followed up to 6 months）.Results The cure rate of observation group and control group was 86.67% and90.00% respectively,and there was no significant difference（P〉0.05）.The length of hospital stay,blood loss,duration of postoperative pain,wound healing time and Wexner anal incontinence score in the observation group were better than control group（P〈0.05）.Conclusion The ligation of inter sphincteric stula tract had advantages of Smaller surgical trauma,shorter postoperative pain time and wound healing time,lower recurrence rate in treatment of patients with the complex anal fistulas,at the same time,it can effectively avoid the anal sphincter injury and fully maintain self-control function of the anal sphincter.So,the ligation of inter sphincteric stula tract has high clinical value in treatment of patients with the complex anal fistulas.