改良式经括约肌间瘘管结扎术对高位复杂性肛瘘肛门功能的影响

Effect of modified ligation of the intersphincteric fistula tract on anal function of high complex anal fistula

目的探讨改良式经括约肌间瘘管结扎术(LIFT)对高位复杂性肛瘘(CAF)肛门功能的影响。方法选取2020年2月至2021年1月江西省宜春市中医院收治的62例高位CAF患者作为研究对象,采用随机数字表法将其分为观察组(31例)与对照组(31例)。观察组患者采用改良式LIFT治疗,对照组患者采用切开挂线术治疗。术后均随访8个月。比较两组患者的治疗效果、临床相关指标、肛门功能、并发症及复发情况。结果两组患者的治疗总有效率比较,差异无统计学意义(P>0.05);观察组患者的手术时间长于对照组,切口愈合时间及住院时间短于对照组,视觉模拟评分法(VAS)评分、Wexner评分低于对照组,差异有统计学意义(P<0.05);观察组患者的并发症总发生率及复发率低于对照组,差异有统计学意义(P<0.05)。结论改良式LIFT用于高位CAF治疗中,可取得与切开挂线术相同的效果,且在缩短切口愈合时间、减轻疼痛及保护肛门功能方面更具优势,可减少并发症的发生及疾病的复发。

Objective To investigate the effect of modified ligation of the intersphincteric fistula tract(LIFT)on anal function of high complex anal fistula(CAF).Methods A total of 62 patients with high CAF treated in Yichun Hospital of Traditional Chinese Medicine in Jiangxi Province from February 2020 to January 2021 were selected as the research objects.They were divided into observation group(31 cases)and control group(31 cases)by random number table method.The patients in the observation group were treated with modified LIFT,and the patients in the control group were treated with incision and thread hanging.They were followed up for 8 months.The treatment effect,clinical related indexes,anal function,complications and recurrence of the two groups were compared.Results There was no significant difference in the total effective rate between the two groups(P>0.05).The operation time of the observation group was longer than that of the control group,the wound healing time and hospital stay were shorter than those of the control group,and the visual analogue scale(VAS)score and Wexner score were lower than those of the control group,with statistically significant differences(P<0.05).The total incidence rate and recurrence rate of complications in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion The modified LIFT can achieve the same effect as incision and thread hanging in the treatment of high CAF,and has more advantages in shortening the wound healing time,reducing pain and protecting anal function,and can reduce complications and disease recurrence.