经括约肌间瘘管结扎术与切开挂线术治疗经括约肌肛瘘的临床效果比较

Comparison of postoperative sphincter fistula ligation and incision and suture for postoperative pain,anal function and wound healing time of sphincter anal fistula

目的比较经括约肌间瘘管结扎术与切开挂线术治疗经括约肌肛瘘术后疼痛、肛门功能以及创面愈合时间的疗效。方法经括约肌肛瘘病人124例,将124例病人分成两组,试验组60例,行经括约肌间瘘管结扎术;对照组64例,行切开挂线术。比较两组的肛门失禁评分、肛门功能、术后疼痛、创面愈合时间和临床疗效。结果对照组肛门失禁总分为(8.68±1.65)分,试验组为(7.03±1.46)分;对照组肛门功能总分(6.71±0.93)分,试验组为(8.04±1.11)分;对照组术后疼痛评分为(6.22±1.24)分,试验组为(3.52±1.06)分,两组以上指标比较,差异均有统计学意义(P<0.05).对照组创面愈合时间为(5.31±1.32)天,试验组为(5.78±1.43)天;对照组临床总有效率为95.31%,试验组为88.33%,两组比较,差异无统计学意义(P>0.05)。结论经括约肌间瘘管结扎术能够缓解经括约肌肛瘘病人术后疼痛,促进其肛门功能的提高,且临床疗效与切开挂线术比较无明显差异。

Objective To compare the curative effect of postoperative sphincter fistula ligation and incision and suture for postoperative pain,anal function and wound healing time of sphincter anal fistula.Methods The date of 124 patients with sphincter anal fistula were retrospectively analyzed.Among them,60 patients who underwent sphincter fistula ligation were set as the study group,and 64 patients who underwent incision and suture were set as the control group.Anal incontinence score,anal function,postoperative pain,wound healing time and clinical efficacy were compared between two groups.Results The total score of anal incontinence in the control group(8.68±1.65)was significantly higher than that(7.03±1.46)in the study group,and the difference was statistically significant(P<0.05).The total anal function score of the control group(6.71±0.93)was significantly lower than the total anal function score of the experimental group(8.04±1.11),and the difference was statistically significant(P<0.05).The postoperative pain score of the control group(6.22±1.24)was significantly higher than that of the experimental group(3.52±1.06),the difference was statistically significant(P<0.05).The wound healing time of the control groupand the test There was no significant difference in the wound healing time(5.78±1.43)between control group [(5.31±1.32)d] and study group[(5.78±1.43)d](P>0.05).The total effective rate of the control group was 95.31%,which was not significantly different from the total clinical effective rate of the experimental group(88.33%)(P>0.05).Conclusion Ligation of sphincter fistula can significantly alleviate postoperative pain in patients with sphincter anal fistula and promote the improvement of anal function.There is no significant difference between clinical efficacy and incision and suture.It can flexible used as an ideal procedure for anal fistula in clinical practice.