AEM补片法联合痰管结扎术治疗肛痰的临床疗效研究

Effect of AEM mesh combined with ligation of fistula tract in the treatment of anal fistula

目的研究瑞诺脱细胞异体真皮基质(AEM)补片法联合瘘管结扎术治疗肛瘘的临床疗效。方法纳入2017年2月至2017年12月广东医科大学附属深圳南山区人民医院240例肛瘘患者作为研究对象,随机抽签分为两组,每组各120例。观察组行AEM补片法联合瘘管结扎术,对照组行常规瘘管切开挂线术。比较两组手术相关情况、疗效、复发情况、术后肛门功能及并发症发生情况。结果术后第3 d,观察组疼痛程度较对照组轻(P <0.05);观察组住院时间和创面愈合时间较对照组短(均P <0.05),两组手术时间差异无统计学意义(P> 0.05)。两组治愈率和显效率比较,差异均无统计学意义(均P> 0.05),观察组复发率低于对照组(P <0.05)。观察组术后Wexner评分低于对照组,观察组术后并发症总发生率低于对照组,差异均有统计学意义(均P <0.05)。结论 AEM补片法联合瘘管结扎术与常规瘘管切开挂线术治疗肛瘘疗效相当,前者可减轻术后疼痛、促进早期恢复、减少并发症的发生及降低复发率。

Objective To investigate the clinical effect of acellularextracellular matrix （AEM） mesh combined with ligation of fistula tract in treating anal fistula. Methods 240 patients with anal fistula who were treated in the Affiliated Hospital of Guangdong Medical University People＇s Hospital of Nanshan District, Shenzhen, between Feb 2017 and Dec 2017 were recruited as study subjects and randomly assigned to two groups, with 120 patients in each group. Patients in the treatment group received AEM mesh combined with ligation of fistula tract and patients in the control group received routine seton. Indices related to the operation, effectiveness, recovery, and postoperative anal function and complications were compared between the two groups. Results Overall pain at the 3ra day after operation was lower in the treatment group than in the control group（P 〈 0.05）. Duration of hospitalization and time to wound healing were shorter in the treatment group than in the control group （P 〈 0.05）. Duration of operation was similar between the two groups （P 〉 0.05）. There was no significant difference in heal rate and effective rate between the two groups（P 〉 0.05）. Recurrence rate was lower in the treatment group than in the control group（P 〈 0.05）. Postoperative Wexner score was lower in the treatment group than in the control group（P 〈 0.05）. Overall incidence of postoperative complications was significantly lower in the treatment group than in the control group（P 〈 0.05）. Conclusion Effectiveness was comparable between AEM mesh combined with ligation of fistula tract and routine seton in treating anal fistula. However, the former can reduce postoperative pain, promote early recovery, reduces complications, and lower recurrence.