经括约肌间瘘管结扎术与肛瘘切开术治疗低位单纯性肛瘘

Ligation of Intersphincteric Fistula Tract versus Fistulotomy in Treatment of Simple Low Anal Fistula

目的:比较经括约肌间瘘管结扎术(LIFT)与肛瘘切开术治疗低位单纯性肛瘘的临床效果和安全性。方法:采用随机、盲法、平行、对照的临床研究方法,将90例符合纳入标准的低位单纯性肛瘘患者随机分为观察组和对照组各45例,观察组行LIFT术治疗,对照组行肛瘘切开术治疗,比较两组手术时间、术中出血量、住院时间、住院费用、创面愈合时间、临床总有效率、术后肛门疼痛、肛门功能、并发症、复发率、患者满意度。结果:观察组手术时间(34.7±4.06)min,长于对照组的(21.7±3.91)min;观察组创面愈合时间(13.49±2.73)d,明显短于对照组的(21.67±2.81)d(P<0.05)。观察组术后疼痛评分和肛门功能评分在各时点均低于对照组(P<0.05)。两组在术中出血量、住院时间、住院费用、总有效率、并发症发生率、复发率、患者满意度方面差异无统计学意义(P>0.05)。结论:LIFT术治疗低位单纯性肛瘘,能缩短创口愈合时间、减轻术后疼痛,且有效保护肛门括约肌功能;但在手术时间和治愈率稳定性方面,与肛瘘切开术比较不具备优势。

Objective To compare the effect of ligation of intersphincteric fistula tract (LIFT) and fistulectomy in the treatment of simple low anal fistula. Methods Totally 90 cases of patients with the same type were randomly divided into observation group and control group by single-blind, randomized and parallelcontrolled research methods, with 45 cases in each group. Observation group were treated by LIFT and control group by fistulectomy. The operation time, intraoperative bleeding volume, hospital stays, hospital fees, cure rate, healing time, postoperative pain sore, postoperative anal function, total incidence rate of complications, recurernce rate and satisfaction rate were compared between the two groups. Results The operation time of the observation group [(34.7±4.06) min] was longer than that of the control group [(21.7±3.91) min]. The wound healing time of the observation group [(13.49±2.73) d] was shorter than that of the control group [(21.67±2.81) d], and the difference was statistically significant (P <0.05). The postoperative pain scores and Wexner scores in the observation group were lower than those in the control group at all time points, and the difference was statistically significant (P <0.05). There was no significance in intraoperative bleeding volume, hospital stays, hospital fees, cure rate, total incidence rate of complications, recurernce rate and satisfaction rate (P >0.05). Conclusion LIFT can shorten wound healing time, relieve postoperative pain and protect postoperative anal function, but it has no comparative advantage with fistulectomy in terms of operation time and cure rate.