拖线疗法治疗复杂性肛瘘的疗效及对肛肠动力学的影响

目的探讨拖线疗法治疗复杂性肛瘘的疗效及对肛肠动力学的影响.方法选取2016年6月至2019年12月复杂性肛瘘患者80例,随机分为观察组(拖线疗法)与对照组(切开或切除术),每组各40例,评价治疗效果和不良反应,测量治疗前后肛门直肠压力.结果观察组治愈时间短于对照组(P<0.05)同,观察组总有效率高于对照组(P<0.05),观察组创伤面积小于对照组(P<0.05).观察组患者无肛门变形、失禁等并发症,2例患者出现局部潮红和瘙痒,对症处理后症状消失.对照组患者中有3例出现不同程度的肛门周围凹陷性瘢痕变形和肛门失禁.观察组和对照组患者手术前后肛管舒张压、肛管最长收缩时间比较均差异无统计学意义(P>0.05),两组患者术后肛管最大收缩压、直肠静息压、肛管静息压较术前均下降(P<0.05),但观察组患者术后肛管最大收缩压、肛管静息压下降幅度比对照组小,差异有统计学意义(P<0.05).结论拖线疗法治疗复杂性肛瘘患者疗效较好,可明显缩短治愈时间、减少创面面积,可促进肛肠功能恢复,值得推广.

Objective To investigate the effect of thread drawing therapy on complex anal fistula and its in fluence on anorectal dynamics.Methods 80 patients from June 2016 to December 2019 with complex anal fistula in our hospital were randomly divided into the experimental group and the control group,40 patients for each group.The experimental group used thread drawing therapy on complex anal fistula,the control group used incision or resection methods.The therapeutic effects and adverse reactions were evaluated and the anorectal pressure was measured before and after treatment.Results The cure time of the experimental group was shorter than that of the control group(P<0.05),the total effective rate of the experimental group was significantly higher than that of the control group(P<0.05),the wound area of the experimental group was significantly smaller than that of the control group(P<0.05).There were no complications such as anal deformation and incontinence in the experimental group,and local flushing and pruritus occurred in 2 patients,the symptoms disappeared after symptomatic treatment.In the control group,3 patients had varying degrees of depressed scar deformation around the anus and anal incontinence.The experimental group and the control group before and after surgery in patients with anal maximal diastolic blood pressure,anal longest contraction time were no statistically significant differences(P>0.05),the two groups of patients with postoperative anal canal maximum systolic pressure,rectal resting pressure,anal canal resting pressure decreased compared with preoperative(P<0.05),but the experimental group of patients with postoperative anal canal maximum systolic pressure,anal canal resting pressure drop was smaller than those of the control group,and the difference was significant(P<0.05).Conclusion The treatment of complex anal fistula with thread dragging therapy has a better curative effect,which can obviously reduce the cure time and the wound area,and promote the recovery of anorectal function.It is worth popularizing.