拖线置管垫棉综合疗法治疗高位复杂性肛瘘的疗效观察

Efficacy of combined therapy of thread-dragging, cathetering and cotton pad in the treatment of high complex anal fistula

目的观察拖线置管垫棉综合疗法治疗高位复杂性肛瘘的疗效。方法高位复杂性肛瘘患者80例,随机分为对照组(n=40)和观察组(n=40)。对照组以切开挂线法治疗,观察组以拖线置管垫棉综合疗法治疗,对两组的术后疼痛评分、创面愈合情况、创面愈合时间、治愈率、复发率进行比较。结果术后第10、14天,观察组的疼痛评分明显低于对照组,创面愈合率高于对照组(均P<0.01)。观察组患者术后创面愈合时间短于对照组(P<0.01)。术后3个月,观察组的肛管收缩压高于对照组(P<0.05),内、外括约肌长度均长于对照组(P<0.01),Wexner评分显著低于对照组(P<0.01)。而两组的治愈率及术后6个月的复发率差异均无统计学意义(P>0.05)。结论拖线置管垫棉综合疗法治疗高位复杂肛瘘可减轻患者痛苦,有利于伤口愈合,而且可以有效保护肛门功能,提升患者生活质量。

Objective To investigate the efficacy of combined therapy of thread-dragging, cathetering and cotton pad in the treatment of high complex anal fistula. Methods Eighty patients with high complex anal fistula were randomly divided into the Control Group(n=40) and Observation Group(n=40). The Control Group was treated with incision and suture method, and the Observation Group was treated with combined therapy of thread-dragging, cathetering and cotton pad. The postoperative pain score, wound healing, wound healing time, cure rate, and recurrence rate were compared between the two groups. Results On the 10 th and 14 th day after operation, the Observation Group had the pain score significantly lower than the Control Group, the wound healing rate higher than the Control Group(P<0.01), and the wound healing time shorter than the Control Group(P<0.01). Three months after operation, the Observation Group had the anal systolic pressure higher than the Control Group(P<0.05), the length of internal and external sphincter longer than the Control Group(P<0.01), and the Wexner score significantly lower than the Control Group(P<0.01). There was no significant difference in the cure rate and recurrence rate between the two groups(P>0.05). Conclusion The treatment of high-complex anal fistula with combined therapy of thread-dragging, cathetering and cotton pad can reduce the pain of patients, facilitate wound healing, effectively protect the anal function and improve the quality of life of patients.