腔内置管负压引流术治疗高位肛周脓肿的效果及对创面愈合的影响

Effect of Negative Pressure Drainage with Intracavitary Tube on High Perianal Abscess and Its Influence on Wound Healing

目的探讨腔内置管负压引流术治疗高位肛周脓肿的效果及对创面愈合的影响。方法选择2019年1月~2020年1月我院收治的70例高位肛周脓肿患者作为研究对象,根据治疗方法不同分为对照组30例和观察组40例。对照组采用传统的切开挂线法治疗,观察组采用腔内置管负压引流术治疗,比较两组手术情况(手术时间、术中出血量、住院时间及创面愈合时间)、临床疗效、疼痛程度(VAS评分)、手术前及手术后1天血清白细胞、TNF-α、IL-6及C反应蛋白(CRP)水平。结果观察组治疗总有效率为87.50%,高于对照组的73.33%,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量、住院时间、创面愈合时间少于对照组,差异有统计学意义(P<0.05);观察组轻度疼痛、中度疼痛患者多于对照组,重度疼痛患者少于对照组,差异有统计学意义(P<0.05);治疗后两组血清白细胞、TNF-α、IL-6及CRP水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论与传统的切开挂线法相比,腔内置管负压引流术治疗高位肛周脓肿临床疗效较高,患者疼痛程度轻,手术切口小,术后创面愈合快,住院时间少,感染控制程度快。

Objective To explore the effect of negative pressure drainage with endoluminal tube in the treatment of high perianal abscess and its influence on wound healing.Methods 70 patients with high perianal abscesses admitted to our hospital from January 2019 to January 2020 were selected as the research objects.According to different treatment methods,they were divided into control group with 30 cases and observation group with 40 cases.The control group was treated with the traditional incision and thread-drawing method,and the observation group was treated with negative pressure drainage with an internal tube.Compare the two groups of surgery(operating time,intraoperative blood loss,hospital stay and wound healing time),clinical efficacy,pain degree(VAS score),Serum white blood cell,TNF-α,IL-6 and C-reactive protein(CRP)levels before and 1 day after surgery.Results The total effective rate of treatment in the observation group was 87.50%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05);There was no statistically significant difference in operation time between the two groups(P>0.05);The amount of blood loss,hospital stay,and wound healing time in the observation group were less than those in the control group,the difference was statistically significant(P<0.05);There were more patients with mild pain and moderate pain in the observation group than in the control group,and fewer patients with severe pain than the control group,the difference was statistically significant(P<0.05);After treatment,the levels of serum white blood cells,TNF-α,IL-6 and CRP in the two groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion Compared with the traditional incision and thread-drawing method,the negative pressure drainage with the endoluminal tube has a higher clinical effect in the treatment of high perianal abscess.The patient has low pain,small surgical incision,quick postoperative wound healing,short hospital stay,and quick infection control.