两种术式治疗复杂性肛瘘的临床疗效比较

Comparison the clinical effects of two different surgical methods in the treatment of complex anal fistula

目的探讨两种不同手术方式治疗复杂性肛瘘的临床疗效。方法选取2012年1月~2014年12月在我科住院的复杂性肛瘘68例,数字表法随机分成两组,治疗组38例采用联合术式,即内口扩创清除、肌间瘘管切开挂线、肌外瘘管隧道式拖线引流。对照组30例采用传统的切开挂线术。观察临床疗效、创面愈合时间、肛门功能,随访1年后的复发率。结果治疗组一次性痊愈率(92.1%)与对照组(83.3%)比较,高于对照组,但差异无统计学意义(P>0.05);治疗组平均创面愈合时间为(25.45±6.98)d,与对照组相比(34.67±6.88)d,差异有统计学意义(P<0.05);两组患者肛门功能差异无统计学意义(P>0.05),随访1年无复发。结论切、挂、拖联合术式治疗复杂性肛瘘具有疗效确切、微创、创面愈合时间短、保护肛门功能、复发率低等优点。

Objective To compare the clinical effects of two different surgical methods in the treatment of complex anal fistula. Methods 68 hospitalized patients from January 2012 to December 2014 were randomly divided into two groups. Patients in treatment group （38 cases） were treated with combined surgical procedures, those were debridement to clear internalopening, incison and thread-drawing for internal muscle fistula, and drainage tunnel to take off the line for external muscle fistula. Patients in control group （30cases） were treated with incison and thread-drawing. The clinical effects,healing time of the wound, anal fuction, recurrence after follow-up 1 year were observed. Results The one-time cure rate of the treatment group was 92.1%,the control group was 83.3%, and there was no significant difference, but the treatment group was higher than the control group （P 〉 0.05）.The average wound healing time of treatment group was （25.45 ± 6.98 ） days,the control group was 34.67 ± 6.88 days, and there were significant differences （P 〈 0.05）.The two groups of patients did not appear completeness anal incontinence, and there was no recurrence after follow-up of 1 year （P 〉 0.05）. Conclusion The treatment of complex anal fistula with combined surgical procedures for incison and thread-drawing and drainage tunnel to take off the line has definite effect, minimally invasive, shorter time of wound healing, protection for anal function, and low recurrence rate.