封闭负压引流术与低位切开引流术治疗高位肛周脓肿的疗效对比

Comparison of the efficacy of vacuum sealing drainage and low incision drainage in the treatment of high perianal abscess

目的对比封闭负压引流术与低位切开引流术治疗高位肛周脓肿的临床疗效。方法选取本院2017年7月至2018年7月共76例高位肛周脓肿患者作为研究对象,采用数字随机法,分为A组和B 组各38 例。A 组通过封闭负压引流术进行治疗,B组通过低位切开引流术进行治疗,对比两组临床疗效。结果A组总有效率86.84%,B 组总有效率63.16%,两组对比差异有统计学意义(P < 0.05)。A 组住院时间[(10.95±3.06)d]、创面愈合时间[(18.97±4.30)d]、治疗成本[(4 325.28±256.59)元]均低于B 组[(14.76±3.52)d、(23.28±4.61)d、(4 553.26±271.58)元](P < 0.05),两组手术时间对比差异无统计学意义(P > 0.05)。A 组VAS 评分[(4.25±1.59)分]、Wexner评分[(1.77±0.52)分]均低于B 组[(6.35±1.76)分、(3.63±0.85)分](P < 0.05)。治疗前,两组TNF-α、EGF 对比差异无统计学意义(P > 0.05);治疗后,两组TNF-α低于治疗前,EGF 高于治疗前,且组间对比差异有统计学意义(P < 0.05)。结论封闭负压引流术与低位切开引流术治疗高位肛周脓肿均具有一定的效果,但封闭负压引流术疗效更加明显,且对肛门功能的保护能力较强,患者术后疼痛较小,愈合速度较快,值得推广应用。

Objective To compare the clinical efficacy of vacuum sealing drainage and low incision drainage in the treatment of high perianal abscess. Methods A total of 76 patients with high perianal abscess from July 2017 to July 2018 were enrolled in our hospital, and they were divided into group A and group B with the digital randomization method, 38 patients in each group. Group A was treated by vacuum sealing drainage, and group B was treated by low incision drainage. The clinical efficacy of the two groups was compared. Results The total effective rate of group A was 86.84%, and that of group B was 63.16%, with statistically significant difference between the two groups (P<0.05). The hospital stay [(10.95±3.06) d], wound healing time [(18.97±4.30) d], treatment cost [(4 325.28±256.59) Yuan] in group A were all lower than those in group B [(14.76±3.52) d,(23.28±4.61) d,(4 553.26±271.58) Yuan](P<0.05), there was no statistically significant difference in the operative time between the two groups (P>0.05). VAS score [(4.25±1.59)] and Wexner score [(1.77±0.52)] in group A were all lower than those in group B [(6.35±1.76),(3.63±0.85)](P<0.05). Before the treatment, there were no statistically significant differences in the levels of TNF-α and EGF between the two groups (P>0.05);after the treatment, the level of TNF-α in the two groups were lower than those before the treatment, the level of EGF in the two groups were higher than those before the treatment, there were statistically significant differences between the two groups (P<0.05). Conclusions Vacuum sealing drainage and low incision drainage have a certain effect in the treatment of high perianal abscess. The effect of vacuum sealing drainage is more obvious, and has stronger protective capability of anal function, with less postoperative pain, faster healing speed, which is worth promoting.