肛旁置管冲洗联合负压引流在肛周脓肿治疗中的应用效果

Effect of perianal tube washing combined with negative pressure drainage on perianal abscess

目的探讨肛旁置管冲洗联合负压引流在肛周脓肿治疗中的应用效果。方法选取东莞市望牛墩医院2017年1月至2019年12月收治的肛周脓肿患者60例为研究对象,按随机数字表法分为对照组与观察组,每组30例。对照组给予传统术式切开引流术治疗,观察组给予肛旁置管冲洗联合负压引流术治疗,两组均治疗1个月。治疗后评估两组患者临床治疗效果,观察记录愈合时间、住院费用及住院时间;采用疼痛视觉模拟量表(VAS)评分评价两组患者术前、术后1 d、术后3 d及术后5 d后肛门疼痛;评估两组患者的肛门功能;比较两组患者肛瘘形成、肛门狭窄以及肛周脓肿复发等并发症发生率。结果观察组愈合时间、住院费用及住院时间均较对照组缩短(P<0.05)。术前两组患者VAS评分比较差异未见统计学意义(P>0.05)。术后1 d、术后3 d以及术后5 d观察组VAS评分明显较对照组改善幅度更大(P<0.05)。观察组肛门功能正常率明显高于对照组(P<0.05)。两组患者肛门功能部分失禁率、功能完全失禁率比较差异未见统计学意义(P>0.05)。观察组肛瘘形成3例,肛门狭窄1例,肛周脓肿复发1例;对照组肛瘘形成4例,肛门狭窄2例,肛周脓肿复发1例;两组患者术后并发症发生率比较差异未见统计学意义(χ^2=0.41,P>0.05)。结论肛旁置管冲洗联合负压引流在肛周脓肿治疗中能明显缩短愈合时间及住院时间,降低疼痛,促进术后肛门功能改善,术后并发症发生率较低,可有效促进患者快速康复。

Objective To investigate the effect of the treatment of perianal abscess by the treatment of perianal catheterization and washing combined with negative pressure drainage.Methods Sixty patients with perianal abscess admitted to Dongguan Wangniudun Hospital from January2017 to December 2019 were selected as the study objects.They were randomly divided into control group and observation group according to the method of digital table,with 30 cases in each group.The control group was treated with traditional incision and drainage,the observation group was treated with perianal tube washing and negative pressure drainage,both groups were treated for one month.After treatment,the clinical treatment effect of the two groups was evaluated,the healing time,hospitalization cost and hospitalization time were observed.The pain of anus was evaluated by VAS before operation,1 day after operation,3 days after operation and 5 days after operation.The incidences of anal fistula,anal stenosis and perianal abscess recurrence were compared between the two groups.Results The healing time,hospitalization cost and hospitalization time of the observation group were shorter than those of the control group(P<0.05).There was no significant difference in VAS score between the two groups before operation(P>0.05).The VAS score of the observation group was significantly improved than that of the control group(P<0.05).The normal rate of anal function in the observation group was significantly higher than that in the control group(P<0.05).There were no significant differences in the partial incontinence rate of anal function or complete incontinence rate of anal function between the two groups(P>0.05).There were 3 cases of anal fistula,1 case of anal stenosis and 1 case of perianal abscess recurrence in the observation group.There were 4 cases of anal fistula and 2 cases of anal stenosis in the control group.There was no significant difference in the incidence of postoperative complications between the two groups(χ^2=0.41,P>0.05).Conclusions In the treatment of perianal abscess,the perianal catheterization and washing combined with negative pressure drainage can significantly shorten the healing time and hospitalization time,reduce the pain,promote the improvement of anal function,reduce the incidence of postoperative complications,and effectively promote the rapid recovery of patients.