瘘管潜剥结合多孔浮线引流术治疗复杂性肛瘘疗效观察

Tunnel fistulectomy with muitiseton drainage in treatment of complicated anal fistula

将2015年9月至2016年8月宁波大学医学院附属医院收治的77例复杂性肛瘘患者，按入院当天所在月份分为A组（奇数月，38例）和B组（偶数月，39例），分别采用瘘管潜剥结合多孔浮线引流术和肛瘘切除挂线术治疗。两组的手术时间[（28.6±2.4）与（26.6±2.7）min]差异无统计学意义（P〉0.05）；A组术后疼痛程度评分[（2.2±0.84）分]、创面面积[（3.7±0.84） cm2]、创面愈合时间[（23.4±2.41）d]、手术治愈率（97.4%）、术后1年内复发率（5.3%），均优于B组[（4.2±1.3）分、（7.28±1.83） cm2、（38.8±3.49）d、79.5%、25.6%]；A组术后肛肠动力学指标明显优于B组，差异均有统计学意义（均P〈0.05）。瘘管潜剥结合多孔浮线引流术治疗复杂性肛瘘术后疼痛轻、恢复快、肛门功能损伤小，有更好的远期临床疗效。

Seventy seven patients with complicated anal fistula were randomly assigned to receive tunnel fistulectomy with multiseton drainage （group A, n=38） or traditional fistulectomy （group B, n=39） for treatment.The clinical data and the treatment outcomes of two groups were compared.There was no significant difference in operation time between two groups （P〉0.05）. However, group A was significantly superior to group B in postoperative pain Numerical Pain Rating Scak （NPRS） score [（2.2±0.84） vs. （4.2±1.3）, P〈0.05）], wound surface area [（3.7±0.84） cm2vs. （7.28±1.83） cm2,P〈0.05], wound healing time [（23.4±2.41） d vs. （38.8±3.49） d, P〈0.05 ], cure rate（97.4% vs. 79.5%, P〈0.05） and recurrent rate 1 year after surgery（5.3% vs. 25.6%, P〈0.05）. The postoperative anorectal dynamic parameters of group A were also better than those of group B （P〈0.05）. Compared to traditional fistulectomy, the tunnel fistulectomy with multiseton drainage has advantages of less pain, faster recovery, less disturbance in anal function and better long-term clinical effect in treatment of complicated anal fistula.