经括约肌间瘘管结扎术治疗复杂性肛瘘的临床体会

Clinical Experience of Ligation of the Intersphincteric Fistula Tract in the Treatment of Complicated Anal Fistula

目的探究经括约肌间瘘管结扎术（LIFT）在复杂性肛瘘治疗中的临床应用效果。方法选取2017年1-6月就诊于沈阳市肛肠医院的复杂性肛瘘患者60例，随机法分成观察组和对照组各30例。观察组采用经括约肌间瘘管结扎术，对照组采用传统切割挂线术。对两组进行临床数据资料的比对分析，以评价LIFT的治疗效果。结果治疗后，治疗总有效率观察组为86．67％，对照组为76．67％，差异无统计学意义（P〉0．05）；观察组平均创面愈合时间和平均住院时间均短于对照组，差异有统计学意义（P〈0．05）；观察组患者术后疼痛及肛门功能评分均优于对照组，差异有统计学意义（P〈0．05）。结论经括约肌间瘘管结扎术治疗复杂性肛瘘，能够显著缓解患者术后疼痛，并能够完整保留肛门括约肌功能，且安全性高、创伤小，值得临床应用推广。

Objective To explore the clinical effect of ligation of the intersphincteric fistula tract in the treatment of complicated anal fistula. Methods We choosed 60 patients with complicated anal fistula, which were collected from Shenyang Anorectal Hospital from January, 2017 to June, 2017, and randomly divided into treatment group and control group （n=30 each group）. Patients in the treatment group were treated with ligation of intersphincteric fistula tract, while the patients in the control group were treated with traditional incision-thread-drawing procedure. The clinical data of two groups were retrospectively analyzed and compared to evaluate the clinical effect of the LIFT therapy. Results After the surgical treatment, there were no significant differences between treatment and control groups （86.67% vs. 76.67%, P〉0.05）. The average wound healing time in observation group （23.89-4-3.67）d and average length of hospital stay （10.54±2.21）d were significantly shorter than those in the control group （P〈0.05）. The postoperative pain and anal function in the treatment group were significantly better than control group （P〈0.05）. Conclusion The ligation of the intersphincteric fistula tract could significantly alleviate postoperative pain and preserve anal sphincter function in the treatment of complex anal fistula. The ligation of the intersphincteric fistula tract is safe and has small incision, which is worthy of application extensively.