超声引导下置管引流术治疗高位肛周脓肿对照临床观察研究

Clinical Study on Ultrasound-guided Catheter Drainage in Treatment of High Perianal Abscess

目的:观察超声引导置管引流术治疗高位肛周脓肿的疗效。方法:将120例高位肛周脓肿患者按照随机数字表法分为治疗组和对照组各60例,治疗组采用超声引导下置管引流术治疗,对照组采用常规置管引流术治疗,比较两组术后第3、7、1天肛门疼痛和脓腔渗液情况,出现出血(大于20mL)、尿潴留、发热(>38.5℃)等并发症的情况,术后1个月总有效率、创面愈合时间,随访6个月的脓肿复发率及成瘘率。结果:治疗组创面完全愈合时间明显少于对照组(P<0.01);两组间术后第3天疼痛评分和渗液评分差异无显著性统计学意义(P>0.05),术后第7、14天疼痛评分和渗液评分有显著性差异(P<0.05);两组术后出现出血、尿潴留的发生率无显著差异(P>0.05),治疗组出现发热的发生率(3.33%)明显优于对照组(13.33%)(P<0.05)。术后1个月总有效率,治疗组明显优于对照组(P<0.05);随访半年,两组复发形成肛瘘病例,治疗组(13.33%)明显少于对照组(30%)(P<0.05)。结论:超声介入高位肛周脓肿置管引流术的术前、术中、术后,安全可行,疗效显著。

Objective To observe the clinical efficacy of ultrasound-guided catheter drainage in treatment of high perianal abscess.Methods The patients with high perianal abscess hospitalized(120 cases)were divided into treatment and control groups according to the digital random table method.The patients in treatment group were treated with catheterization under ultrasound guidance while the patients in control group were treated with regular catheterization.The anal pain and exudation after 3,7 and 14 d of operation,bleeding,uroschesis,fever conditon,wound healing time,total effective rate after one month,recurrence rate and rate of anal fistula formation after six month were compared.Results The patients in treatment group needed less wound healing time than the control group,with statistically significant differences(P<0.01).The scores of anal pain and exudation after 3 d of operation had no significant difference.The pain scores and exudation scores of the treatment group were less than the control group after 7 and 14 d of operation,with statistically significant differences(P<0.05).The bleeding and uroschesis occurrence rate of two groups had no significant difference(P<0.05).The fever occurrence rate of treatment group was much lower than that in control group,with statistically significant difference(P<0.05).The total effective rate after one month in treatment group was significantly higher than that in control group(P<0.05).Followed up for six month,the recurrence rates of the two groups were 3.33%and 8.33%,with no significant difference(P>0.05),and the anal fistula formation in treatment group was much less than that in control group,with significant difference(P<0.05).Conclusion The pre-,mid-and postoperative of high perianal abscess catheterization under ultrasound intervenion was safe,feasible,valid,and worthy of clinic application.