肛门病不同术式对肛门控便能力的影响

Impact of various operative modality used to heal the disease of anus on the anus control ability

目的探讨肛门病不同手术方式对肛门控便能力的影响。方法回顾性分析聊城市第二人民医院肛肠科2014年03月至2016年3月间1 455例肛门疾病患者的手术方式与术后肛门控便能力的关系。结果肛周脓肿术后总失禁率为19.6%,肛瘘为14.9%,混合痔为5.6%,肛裂为7.1%。肛周脓肿患者和肛瘘患者术后肛门控便能力比较,差异无统计学意义(Z值=-1.475,P>0.05);Ⅲ、Ⅳ度环状脱垂痔的手术方式对术后肛门控便能力影响的比较,差异有统计学意义(Z值=-6.873,P<0.05);肛周脓肿、肛瘘、肛裂其各自的手术方式对术后肛门控便能力影响的比较,差异无统计学意义(Z值=-1.469,Z值=-1.841,Z值=-0.307,P均>0.05)。结论在选择合理手术方式的前提下,肛周脓肿可以采取一期根治性手术治疗;对于Ⅲ、Ⅳ度环状脱垂痔的吻合器痔上粘膜环切钉合术(PPH)值得临床推广。

Objective To investigate the impact of various operative modality used to heal thedisease of anus on the anus control ability. Methods The relation of anus control ability after operation andthe various operative modality of 1 455 patients underwent anorectal procedures in the department of colorectalsurgery at the Second People′s Hospital of Liaocheng from March 2013 to March 2016 analyzed retrospectively.Results The postoperative incontinence rate of perianal abscess was 19.6%, anal fistula was 14.9%, severehemorrhoid (grade Ⅲ、Ⅳ ) was 5.6% and anal fissure was 7.1%.Anal controllability after surgery used to heal perianalabscess and anal fistula were compared, the differences were not statistically significant (Z=-1.475, P > 0.05).The impact of the various operative modality used to heal severe hemorrhoid (grade Ⅲ、Ⅳ ) on anal controlability were compared, the differences were statistically significant (Z=-6.873, P < 0.05). The impact of thevarious operative modality used to heal perianal abscess on anal control ability were compared, the differenceswere not statistically significant, same as the anal fistula and anal fissure (Z=-1.469, Z=-1.841, Z=-0.307, allP value > 0.05) . Conclusion Under the consideration of reasonable surgical procedures could be choosed,the one-stage radical operation could be adopted on perianal abscess, the procedure for prolapse and hemorrhoid(PPH) could be popularized to heal severe hemorrhoid (grade Ⅲ、Ⅳ ) .