Ⅰ期根治术治疗对高位多间隙肛周脓肿患者肛肠动力学及脓肿复发率的影响

Influence of Primary Radical Operation on Anorectal Dynamics and Abscess Recurrence Rate in Patients with High Multi-space Perianal Abscess

目的:探究Ⅰ期根治术治疗对高位多间隙肛周脓肿患者肛肠动力学及脓肿复发率的影响。方法:2016年9月-2020年9月本院行Ⅰ期根治术的高位多间隙肛周脓肿患者103例,按随机数字表法分为根治组50例和引流组53例,根治组采取Ⅰ期根治术治疗,引流组采取切开引流术治疗,比较两组围手术期情况、肛门动力学及脓肿复发情况。结果:根治组术后24 h视觉模拟(VAS)评分、肛门失禁评分(Wexner)及住院时间明显低于引流组(P<0.05);术后3个月,根治组肛管静息压(ARP)、肛管最大收缩压(AMCP)及直肠静息压(RRP)明显高于引流组(P<0.05);术后3个月,根治组脓肿复发3例,占比为6.00%,引流组脓肿复发10例,占比为18.87%,根治组脓肿复发率明显低于引流组(P<0.05)。结论:Ⅰ期根治术治疗高位多间隙肛周脓肿可改善患者肛门功能,提高肛肠动力学指标,缩短住院时间,降低患者脓肿复发率。

Objective:To explore the influence of primary radical operation on anorectal dynamics and abscess recurrence rate in patients with high multispace perianal abscess.Method:A total of 103 patients from September 2016 to September 2020 with high multi-space perianal abscesses treated by primary radical operation were enrolled in the study.According to random number table method,patients were divided into the radical treatment group(n=50)and the drainage group(n=53).Patients treated with primary radical operation were included in the radical operation group,while those treated with incision and drainage were included in the drainage group.The perioperative conditions,anal dynamics and abscess recurrence were compared between the two groups.Result:The postoperative 24 h visual analogue scale(VAS)score,anal incontinence(Wexner)score and the length of hospital stay of the radical operation group were significantly lower and shorter than those of the drainage group(P<0.05).Three months after operation,the anal resting pressure(ARP),anal maximum contraction pressure(AMCP)and resting rectal pressure(RRP)of the radical operation group were significantly higher than those of the drainage group(P<0.05).The abscess recurrence rate in the radical operation group was 6.00%,significantly lower than 18.87%in the drainage group(P<0.05).Conclusion:Primary radical operation can improve the anal function and improve the indexes of anorectal dynamics,shorten the hospital stay,and reduce the abscess recurrence rate in patients with high multi-space perianal abscess.