经括约肌瘘管结扎术与传统肛瘘手术治疗简单性肛瘘的疗效对比分析

Comparative Analysis Ligation of the Inersphincteric Fistual Tract and Fistulectomy in the Treatment of Fistula-in-ano

目的研究经括约肌间瘘管结扎术(LIFT手术)治疗简单性肛瘘的疗效及安全性,为临床治疗方案的选择提供依据。方法选择2011年6月-2018年4月收治的416例简单性肛瘘患者,男248例,女168例,所有患者分成两组,其中一组采用LIFT手术治疗(LIFT手术组),另一组采用传统肛瘘切开术和肛瘘切除术(传统手术组),每组208例。对两组患者的治愈率、术后住院时间、平均愈合时间、术后疼痛程度VAS评分、肛门失禁情况Wexner评分和肛管直肠测压的变化等进行对照分析。结果 LIFT手术组治愈率91. 35%(190/208);传统手术组治愈率98. 56%(205/208)。LIFT手术组在总治愈率上与传统手术组并无明显差异(P> 0. 05)。LIFT手术组在术后住院时间、平均创面愈合时间、术后3天内VAS评分、术后1个月Wexner评分方面明显优于传统手术组,差异有统计学意义(P <0. 05)。传统手术组患者术前与术后3个月的肛管直肠测压结果显示,术前与术后肛管最大收缩压差异有统计学意义(P <0. 05)。结论 LIFT手术创伤小、恢复快,无明显疼痛,无肛门失禁发生,是一种治疗肛瘘更加理想的方法。

Objective To investigate the clinical efficacy and security of ligation of the intersphincteric fistula tract（ LIFT） for the treatment of simple anal fistula. Methods A total of 416 patients（ 248 males. 168 felllales） with simple anal fistula were recruited from Xinhua hospital between June2011 and April 2018. These patients were randomly assigned to the experimental group（ n = 208） treated with LIFT or the control group（ n = 208） treated with fistulectomy. The collected data included total cure rate. length of stay. Mean healing time. the Visual Analogue Scale（ VAS）. the incontinence rate. and changes of anorectal manometry. Results LITT group total cure rate was 91. 35（ 190/208）; fistulectomy group total cure rate wsa 98. 56%（ 205/208）. Experimental group is superior to control group in Postoperative hospital stay. Mean healing time. The Visual Analogue Scale（ VAS）and incontinence Wexner score（ P〈 0. 05）. The anorectal pressure of the control group was significantly different before and three months after surgery（ P 〈0. 05）. Conclusions LIFT have the advantage in less trauma,faster surgical healing,less pain and less incontinence rate. Terefore,LIFT maybe a better treatment of simple anal fistula.