高频腔内超声引导下瘘管切开加挂线术治疗复杂性肛瘘的效果

The effect of high-frequency ultrasound incision and threa-drawing in the treatment of complex rectal fstula

目的探讨高频腔内超声引导下行瘘管切开加挂线疗法治疗复杂肛瘘的有效性和安全性。方法选择2015年1月至2016年6月深圳市宝安区松岗人民医院收治的94例复杂性肛瘘患者为研究对象,随机分为对照组(n=47)和治疗组(n=47),对照组行常规瘘管切开加挂线术,治疗组在高频腔内超声引导下行瘘管切开加挂线术。比较两组患者的临床疗效、创口愈合时间、手术前后肛门功能Wexner评分、术后并发症发生情况及和复发率。结果治疗组临床治疗有效率为95.74%,对照组临床治疗有效率为80.85%,差异有统计学意义(P<0.05)。治疗组术后创口愈合时间以及半年内复发率均显著优于对照组,差异均有统计学意义(均P<0.05)。两组术前肛门Wexner评分差异无统计学意义(P>0.05),术后半年中每月治疗组评定的Wexner评分均显著优于对照组(均P<0.05)。治疗组术后并发症总发生率为6.38%,对照组为19.15%,差异无统计学意义(P>0.05)。结论与常规瘘管切开加挂线术相比,高频腔内超声引导下行瘘管切开加挂线术治疗复杂性肛瘘的治愈率及术后患者肛门功能恢复更优,并发症发生率及复发率更低。

Objective To investigate the clinical efficacy and safety of incision and thread-drawing procedure guided by high-frequency ultrasourd in treating patients with complex rectal fistula. Methods A total of 94 cases of patients with complex rectal fistula in our hospital from Jan 2015 to Jun 2016 were divided into control group（n = 47）and treatment group（n = 47）by random sampling method. Patients in control group were treated by incision and thread-drawing procedure,and patients in treatment group were given high-frequency intraluminal ultrasonography guided incision and thread-drawing procedure.Clinical effect,would healing time,Wexner anal function score before and after surgery,postoperative complications and recurrence were compared between the two group. Results The overall effective rate in the treatment group was 95.74%,which was significantly higher than that in the control group（80.85%）（P〈0. 05）. The wound healing time and the recurrence rates in treatment group were significantly better than those in control group（P〈0. 05）. There was no significant difference in Wexnerscores before surgery,and the Wexnerscores after surgery in treatment group were significantly better than those in control group（P〈0. 05）;The recurrence rates in treatment group was 6.38%,and that in control group was 19.15%,with no significant difference between the two groups（P〉0. 05）.Conclusion Iincision and thread-drawing procedure guided by high-frequency intraluminal ultrasonographyhas a high cure rate and low recurrence rate of in treating complex rectal fistula.It is advantageous for the recovery of patients＇ anal function,decreases the complications,with high efficacy and safety.