视频辅助治疗手术对复杂性肛瘘病人症状及预后的影响

Effect of videoscope-assisted surgery on the symptoms and prognosis in patients with complex anal fistula

目的分析视频辅助治疗手术对复杂性肛瘘病人症状以及预后的影响。方法 2017年1月~2018年12月我院肛肠科收治的复杂性肛瘘病人80例,根据手术方法不同分为两组,观察组42例,采用微创视频辅助肛瘘治疗手术,对照组38例,采用传统低位切开高位挂线术治疗,比较两组病人术后治疗疗效以及治疗前后肛门动力学变化情况、肛门功能评分、疼痛评分、各恢复指标、并发症发生情况。结果观察组病人手术治疗疗效明显优于对照组,差异有统计学意义(P<0.05)。两组病人术后肛管静息压、肛管舒张压以及肛管最大收缩压低于术前,观察组术后肛管静息压、肛管舒张压以及肛管最大收缩压明显高于对照组,差异具有统计学意义(P<0.05)。观察组病人术后肛门括约肌、肛门形态评分以及VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组病人住院时间、创面愈合时间、创面面积以及愈后瘢痕面积少于对照组,差异有统计学意义(P<0.05)。观察组病人术后出血、排尿障碍、肛门水肿以及感染等并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论视频辅助治疗手术微创、痛苦小,治疗疗效良好,安全性高。

Objective To analyze the effect of videoscope-assisted surgery on the symptoms and prognosis in patients with complex anal fistula.Methods Eighty patients with complex anal fistula admitted to our general surgery department from January 2017 to December 2018 were divided into observation group(n=42,minimally invasive videoscope-assisted surgery)and control group(n=38,traditional low cut high thread surgery)according to the surgical plan.The postoperative efficacy and anal dynamic changes,anal function score,pain score,recovery index,and complications before treatment were compared between the two groups.Results The efficacy of the observation group was significantly better than that of the control group(P<0.05).After operation,the anal canal resting pressure,anal canal diastolic pressure and maximum anal canal pressure were significantly lower than those before operation;the anal canal resting pressure,anal canal diastolic pressure and maximum anal canal pressure were significantly higher in the observation group than in the control group(P<0.05).The anus sphincter,anal morphology score and VAS score of the observation group were significantly lower than those of the control group(P<0.05).The hospitalization time,wound healing time,wound area and scar area of the observation group were significantly lower than those of the control group(P<0.05).The incidence of postoperative bleeding,dysuria,anal edema and infection in the observation group was significantly lower than that in the control group(P<0.05).Conclusions Videoscope-assisted surgery is minimally invasive and painful with highefficacy and safety,which can effectively improve the prognosis in patients with complex anal fistula.