肛门洗剂熏洗对老年肛瘘患者术后创面恢复及相关生长因子的影响

The effect of anal fumigating-washing lotion on wound recovery and related growth factors in older patients undergoing anal fistula operation

目的研究肛门洗剂熏洗对老年肛瘘术后创面恢复和相关生长因子的影响。方法纳入80例老年肛瘘患者作为研究对象,随机分为两组,每组各40例。两组均接受肛瘘切开挂线术,术后对照组常规高锰酸钾熏洗,观察组予肛门洗剂熏洗。比较两组住院时间、疗效、术后创面恢复效果,记录两组患者术后相关生长因子水平。结果观察组住院时间短于对照组,差异有统计学意义(P<0.05)。两组患者术后4 w总体疗效差异无统计学意义(P>0.05)。观察组术后1 w时创面面积、创面渗液及切口疼痛评分均优于对照组(均P<0.05),观察组创面愈合时间短于对照组(P<0.05)。观察组术后1 w时VEGF和VEGF-2水平均高于术后1 d和对照组(均P<0.05)。结论肛门洗剂熏洗用于老年肛瘘患者术后能促进创面早期愈合,改善创面恢复效果,这可能与中药肛门熏洗促血管生长作用有关。

Objective To study the effect of anal fumigating-washing lotion on wound recovery and related growth factors in older patients undergoing anal fistula operation. Methods 80 older patients of anal fistula were included in the study. They were randomly assigned into two groups, with 40 cases in each group. The two groups were treated with anal fistula incision and seton. After the operation, the control group received routine fumigation and washing with potassium permanganate, while the treatment group received the anal fumigating-washing lotion. The duration of hospitalization, curative effect and the effect of postoperative wound recovery were compared between the two groups. The levels of related growth factors after operation were recorded. Results The duration of hospitalization was shorter in the treatment group than in the control group（P〈0.05）. There was no significant difference in the total effect between the two groups after 4 weeks（P〈0.05）. The wound area, wound fluid and incision pain score were better in the treatment group than in the control group at 1 week after operation（P〈0.05）. Time to wound healing was shorter in the treatment group than that in the control group（P〈0.05）. The level of VEGF and VEGF-2 at 1 week after operation were higher in the treatment group than 1 day after operation and higher than in the control group（P〈0.05）. Conclusion The use of anal fumigating-washing lotion can promote early wound healing and improve the effect of the wound recovery in older patients with anal fistula operation. Its effect could be related to the effect of promoting growth of the blood vessels.