肛瘘切开挂线术联合对口引流术在高位复杂性肛瘘中的效果及其对肛门功能的影响

Efficacy of incision-thread-drawing procedure for anal fistula combined with oral drainage in high-grade complex anal fistula and its effect on anal function

目的探究肛瘘切开挂线术联合对口引流术在高位复杂性肛瘘中效果及对肛门功能影响。方法选择常熟市第二人民医院2019年1月至2020年8月接诊的62例高位复杂性肛瘘患者进行回顾性分析,将其按照治疗方案分为观察组(n=32)和对照组(n=30),对照组行肛瘘切开挂线术,观察组行肛瘘切开挂线术联合对口引流术治疗,比较两组患者临床疗效、肛门功能、住院时间、创面愈合时间及并发症情况。结果观察组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组术后肛管最大收缩压、直肠静息压及肛管静息压与术前比较,差异无统计学意义(P>0.05),对照组肛管最大收缩压、直肠静息压及肛管静息压低于术前,差异有统计学意义(P<0.05);观察组术后肛管最大收缩压、直肠静息压及肛管静息压高于对照组,差异有统计学意义(P<0.05);观察组术后住院时间及创面愈合时间均低于对照组,差异有统计学意义(P<0.05);观察组患者术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论肛瘘切开挂线术联合对口引流术治疗高位复杂性肛瘘患者,可有效提升临床疗效,避免肛门括约肌功能下降,降低并发症总发生率,缩短术后创面恢复时间及住院时间。

Objective To investigate the efficacy of incision-thread-drawing procedure for anal fistula combined with oral drainage in high-grade complex anal fistula and its effect on anal function.Methods A total of 62 patients with high-grade complex anal fistula admitted to Changshu No.2 People's Hospital from January 2019 to August 2020 were retrospectively analyzed and divided into the observation group(n=32)and the control group(n=30)according to the treatment schemes.The control group was treated with incision-thread-drawing procedure for anal fistula,while the observation group was treated with incision-thread-drawing procedure for anal fistula combined with oral drainage.The clinical efficacies,anal function,length of s tay,wound healing tim e,and complications of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group,with statistically significant difference(P<0.05).There were no statistically significant differences in terms of maximum systolic pressure,rectal resting pressure and anal canal resting pressure in the observation group after treatment compared with those before operation(P>0.05),while the above-mentioned indices in the control group were all lower after operation compared with those before operation,and the differences were statistically significant(P<0.05).The maximum systolic pressure,rectal resting pressure and anal canal resting pressure after operation in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).The postoperative length of stay and wound healing time in the observation group were shorter than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion In the treatment of patients with high-grade complex anal fistula,incision-thread-drawing procedure for anal fistula combined with oral drainage can effectively improve the clinical efficacy,avoid anal sphincter dysfunction,reduce the total incidence of complications,and shorten the postoperative wound recovery tim e and length of stay.