低位切开联合引流挂线术治疗高位肛瘘患者的效果

Effects of low incision combined with drainage thread-drawing in treatment of patients with high anal fistula

目的:观察低位切开联合引流挂线术治疗高位肛瘘患者的效果。方法:选取68例高位肛瘘患者为研究对象,按照随机数字表法分为对照组和观察组各34例。对照组采用低位切开联合高位挂线术治疗,观察组采用低位切开联合引流挂线术治疗,比较两组切口愈合时间、术后视觉模拟评分法(VAS)评分和出院时、术后3个月括约肌功能指标[食管下括约肌静息压(LESP)、肛门最大缩榨压(MSP)及肛管静息压(ARP)]水平。结果:观察组切口愈合时间明显短于对照组,术后3 d和术后1周VAS评分均低于对照组,差异有统计学意义(P<0.05);术后3个月,两组LESP水平均高于出院时,且观察组高于对照组,两组MSP、ARP水平均低于出院时,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:低位切开联合引流挂线术治疗高位肛瘘患者可缩短切口愈合时间,降低VAS评分,以及改善括约肌功能指标水平,优于低位切开联合高位挂线术治疗效果。

Objective:To explore effects of low incision combined with drainage thread-drawing in treatment of patients with high anal fistula.Methods:68 patients with high anal fistula were selected as the research objects,and were divided into control group and observation group according to the random number table method,34 cases in each group.The control group was treated with low incision combined with high thread drawing,while the observation group was treated with low incision combined with drainage thread drawing.The incision healing time,the postoperative visual analogue scale(VAS)score,and the sphincter function indexes[lower esophageal sphincter resting pressure(LESP),maximum anal squeeze pressure(MSP)and anal canal rest pressure(ARP)]levels at discharge and 3 months after the surgery were compared between the two groups.Results:The incision healing time of the observation group was significantly shorter than that of the control group;the VAS scores were lower than those of the control group 3 days and 1 week after the surgery;and the differences were statistically significant(P<0.05).3 months after the surgery,the LESP levels of the two groups were higher than those at discharge,and that of the observation group was higher than that of the control group;the MSP and ARP levels of the two groups were lower than those at discharge,and those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).Conclusions:Low incision combined with drainage thread drawing in the treatment of the high anal fistula patients can shorten the incision healing time,reduce the VAS score,and improve the sphincter function index levels.Moreover,it is superior to low incision combined with high thread drawing.