开窗留桥改道术治疗复杂性肛瘘的临床观察

Clinical observation of diversion treatment for complex anal fistula

目的研究分析开窗留桥改道术治疗复杂性肛瘘的临床疗效。方法选取本院接受诊治的60例复杂性低位肛瘘患者,根据随机数表法分为对照组、实验组,各30例。所有患者术前均常规检查影像学等相关检查,并于手术当日早晨清洗肠道,对照组患者采用低位肛瘘切除术治疗,实验组患者实施开窗留桥改道术治疗。比较2组患者治疗效果、术后肛门功能变化、创口愈合时间以及疼痛程度。结果实验组治疗总有效率高于对照组(P<0.05);实验组患者术后1、7、14、21 d的肛门功能Wexner评分均低于对照组,且随着时间延长而不断降低,差异均有统计学意义(P<0.05);实验组患者术后创口愈合时间、术后14 d疼痛VAS评分、术中创面以及术后疤痕大小均低于对照组,差异均有统计学意义(P<0.05)。结论开窗留桥改道术治疗复杂性肛瘘效果显著,术后创口愈合快,能有效缓解临床症状与体征,改善肛门功能,减轻机体疼痛,值得临床推广。

Objective To study the clinical effect of diversion treatment for complex anal fistula.Methods A total of 60 patients with complex anal fistula were enrolled in this study were divided into control group and experimental group according to the random number table method,with 30 cases per group.All patients were given routinely imaging examination and other related checks,and the intestine tract was cleaned in the morning of the operative day.The control group were treated with low anal fistula resection,while the experimental group with diversion treatment.The efficacy of treatment,postoperative anal function,wound healing time and pain were compared between the two groups.Results The total effective rate in the experimental group was higher than that in the control group(P<0.05).The Wexner score of the anus function in the experimental group was lower than that in the control group at 1,7,14 and 21 d after the operation,and the differences were statistically significant(P<0.05).The wound healing time,VAS score on 14 th postoperative day,intraoperative wound area and postoperative scar size were lower in the experimental group than that in the control group(P<0.05).Conclusion Diversion treatment for complex anal fistula has significant efficacy,faster postoperative wound healing,and it can effectively relieve clinical symptoms and signs,improve anal function,reduce body pain,so it is worthy of clinical promotion.