中医挂线两种疗法治疗高位肛瘘临床对比分析

Clinical Analysis of Two Kinds of Traditional Chinese Medicine Seton Therapy for High Anal Fistula

目的探讨低位虚挂与高位实挂两种中医挂线疗法治疗高位肛瘘的疗效及对肛门功能的影响。方法以2013年1月-2018年10月为时限,方便择取该院中医挂线治疗的62例高位肛瘘患者,依据挂线方法不同分为实验组(低位虚挂,31例)和对照组(高位实挂,31例),评价两组疗效与术后肛门功能,观察基本治疗指标、术后疼痛及并发症发生情况,随访统计复发率。结果实验组治疗总有效率(100.0%)与对照组(100.0%)相当,患者创面愈合时间(40.5±9.6)d,创面瘢痕面积(3.3±0.9)cm2,NRS评分(3.1±0.6)分,Wexner评分(0.8±0.5)分,肛门漏液3.23%,肛管缺损0.00%,随访复发率0.00%,各项指标均优于对照组(P<0.05)。结论中医低位虚挂与高位实挂治疗高位肛瘘效果均理想,其中前者创面愈合更佳,患者痛苦小,并发症少,恢复快,对肛门功能影响小,更具临床优势,值得推广应用。

Objective To investigate the effect of low-level virtual suspension and high-level traditional Chinese medicine seton on the treatment of high anal fistula and its effect on anal function. Methods From January 2013 to October 2018, 62 patients with high anal fistula who were treated with Chinese medicine seton were conveniently selected. The experimental group (low virtual suspension, 31 cases) and the control group (high-level hanging, 31 cases) were divided according to the seton method, evaluation of the two groups of efficacy and postoperative anal function, observation of basic treatment indicators, postoperative pain and complications, follow-up statistics recurrence rate. Results The total effective rate (100.0%) of the experimental group was comparable to that of the control group (100.0%). The wound healing time was (40.5±9.6) d, the scar area of the wound was (3.3±0.9) cm2, and the NRS score was (3.1±0.6)points;Wexner score (0.8±0.5)points, anal leakage 3.23%, anal canal defect 0.00%, follow-up recurrence rate 0.00%, all indicators were better than the control group(P<0.05). Conclusion The low-level virtual suspension and high-position operation of Chinese medicine are effective in treating high anal fistula. The former has better wound healing, less pain, less complications, quick recovery, less impact on anal function, and more clinical advantages. It is worthy of popularization and application.