切开挂线选择性缝合术和切开挂线治疗高位复杂性肛瘘的效果对比

Effect comparison of incision,seton,selective suture and incision seton in the treatment of high complex anal fistula

目的通过观察高位复杂性肛瘘患者经切开挂线选择性缝合术和经切开挂线治疗后的临床数据变化,对比两种方法的治疗效果,探讨其中对于高位复杂性肛瘘的治疗更为有效的方法。方法选取2012年4月~2013年4月在我院接受治疗的60例高位复杂性肛瘘患者,采用随机数字表法将其分为观察组和对照组,每组患者均为30例,对观察组患者应用切开挂线选择性缝合术治疗,对对照组患者应用切开挂线治疗,记录两组患者的治愈时间、治愈率、肛门功能评分及并发症的发生等临床情况变化,并对此进行统计分析。结果将两组患者的治愈时间进行比较,显示观察组患者治愈时间短于对照组,差异有统计学意义(P<0.05);将两组患者治愈率情况进行比较,差异有统计学意义(P<0.05);将两组患者的肛门功能评分进行比较,观察组患者的肛门功能恢复得更好,差异有统计学意义(P<0.05);比较两组患者随访半年的复发情况,观察组复发率低于对照组,两组患者均无肛门失禁情况。结论对于高位复杂性肛瘘的治疗,两种方法都有较好的治疗效果,而切开挂线选择性缝合术的治疗效果优于切开挂线治疗,能够使治愈时间大大缩短,一定程度上使治愈率得到提升,患者的肛门功能也能得到较好的恢复,因此切开挂线选择性缝合术是治疗高位肛瘘较好的手术方法,可于临床上进行推广应用。

Objective To observe the change of clinical data of patients with high anal fistula complicatedby incision,Seton,selective suture and incision and seton treatment,to compare the therapeutic effects of the twomethods,and to explore a more effective method for the treatment of high complex anal fistula.Methods60patientswith high complex anal fistula cured in our hospital from April2012to April2013were selected and divided intoobservation group and control group with30cases in each according to random digital method.Patients in observationgroup were treated with incision and Seton selective suture,and patients in control group were treated with incision andSeton.The cure time,cure rate,anal function score and complications of the two groups were compared and analyzed.Results Comparing the cure time of two groups of patients,it showed that the cure time of the observation groupwas shorter than that of the control group,and the difference was statistically significant(P<0.05).The comparisonof the cure rate between the observation group and the control group showed that the former was higher than thelatter(P<0.05).The anal function scores of the two groups were compared,and the anal function of the patients inthe observation group was better.The difference between the two groups was statistically significant(P<0.05).Therecurrence rate of the two groups was followed up for half a year.The recurrence rate of the observation group was lowerthan that of the control group,and there was no fecal incontinence in the two groups.Conclusion For the treatment ofhigh complex anal fistula,two methods have better therapeutic effect.The effect of incision and Seton selective sutureis better than that of incision and thread drawing therapy.It can shorten the healing time and improve the cure rate toa certain extent.The patient’s anal function can also be better recovered.Therefore,the incision and Seton selectivesuture is a better method for the treatment of high anal fistula,and it can be popularized and applied in clinic.