肛旁置管冲洗联合负压引流对肛周脓肿疗效及肛门功能的影响

Clinical efficacy of perianal tube washing combined with negative pressure drainage on anal perianal abscess and anal function

目的探讨肛旁置管冲洗联合负压引流在肛周脓肿患者中的临床效果及对肛门功能的影响。方法选择2015年6月-2017年10月在新疆医科大学附属中医医院住院治疗的肛周脓肿患者100例,根据治疗方法不同分为对照组和观察组,每组50例。对照组采用传统切开引流术治疗,观察组采用肛旁置管冲洗联合负压引流治疗,两组均连续治疗1个月后对治疗效果进行评估。记录并统计两组治疗后手术、愈合、住院时间及住院费用;采用酶联免疫吸附试验测定两组治疗前、治疗后1个月白细胞介素-1α(IL-1α)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平;比较两组临床治疗效果及对患者肛门功能的影响。结果观察组的手术时间、愈合时间、住院时间及住院费用均短或少于对照组(P<0.05);两组治疗后1个月的IL-1α、IL-4、IL-6及TNF-α水平,均低于治疗前(P<0.05);观察组治疗后1个月的IL-1α、IL-4、IL-6及TNF-α水平均低于对照组(P<0.05);观察组治疗后1个月肛门功能正常率高于对照组(P<0.05);观察组治疗后1个月部分功能失禁及严重功能失禁率低于对照组(P<0.05)。结论肛旁置管冲洗联合负压引流用于肛周脓肿患者效果较理想,值得推广应用。

Objective To investigate the clinical effect of perianal tube washing and negative pressure drainage in patients with perianal abscess and their effects on anal function.Methods A total of 100 patients with perianal abscess admitted to hospital from June 2015 to October 2017 were selected and divided into control group(50 cases)and observation group(50 cases)according to different treatment methods.The patients in the control group were treated by traditional incision and drainage.The patients in the observation group were treated with perianal tube washing combined with negative pressure drainage.Both groups were treated continuously for 1 month.After treatment,the therapeutic effect was evaluated.The operation,healing,hospitalization and hospitalization costs of the two groups were recorded and statistically analyzed.The levels of interleukin-la(IL-1α),interleukin-4(IL-4),interleukin-6(IL-6)and tumor necrosis factor-a(TNF-α)were measured.Anal function of the two groups was evaluated from the perspective of normal function,partial functional incontinence and severe functional incontinence.The effects of clinical treatment and anal function on the two groups were compared.Results The time of operation,healing,hospitalization and hospitalization costs of the observation group were shorter(less)than those of the control group(P<0.05).The levels of IL-1α,IL-4,IL-6 and TNF-αin the control group were all lower than those before treatment(P<0.05).The normal anal function of the observation group was higher than that of the control group at 1 month(P<0.05).One month after the treatment,the part of functional incontinence and severe function incontinence rate was lower than that of the control group(P<0.05).Conclusions The combined use of perianal tube washing and negative pressure drainage in perianal abscess patients is effective,which can shorten the healing time,reduce the level of inflammatory cytokines and improve anal function,which is worthy of popularization and application.