高位虚挂线引流与三间隙引流在高位肛周脓肿切除术中的应用效果比较

Comparison of the Effect of High Virtual Thread Drainage and Three Space Drainage in Resection of High Perianal Abscess

目的:分析高位虚挂线引流与三间隙引流在高位肛周脓肿切除术中的应用价值。方法:选取佳木斯市肛肠医院2019年2月-2021年11月收治的102例高位肛周脓肿患者为研究对象,依据随机数字表法分为虚挂线引流组和三间隙引流组,各51例。两组均行高位肛周脓肿切除术,虚挂线引流组采用高位虚挂线引流,三间隙引流组采用三间隙引流。比较两组临床疗效、感染控制时间、创面愈合时间、整体住院时间、肛门功能、疼痛因子及术后不良反应差异。结果:虚挂线引流组总有效率(92.16%)显著高于三间隙引流组(76.47%)(P<0.05)。术后1、2个月,两组肛管静息压、肛管最大收缩压均降低,Wexner评分均升高,虚挂线引流组肛管静息压、肛管最大收缩压均较三间隙引流组更高,Wexner评分较三间隙引流组更低,差异均有统计学意义(P<0.05)。术后3 d,两组5-羟色胺(5-HT)、血清P物质(SP)、去甲肾上腺素(NE)均降低,且虚挂线引流组均显著低于三间隙引流组(P<0.05)。虚挂线引流组感染控制时间、创面愈合时间、住院时间均显著短于三间隙引流组(P<0.05)。虚挂线引流组不良反应发生率显著低于三间隙引流组(P<0.05)。结论:高位虚挂线引流与三间隙引流均有较好的治疗效果,但高位虚挂线引流治疗高位肛周脓肿对肛门功能损伤更小,更能抑制疼痛因子生成,加快恢复速率,降低术后并发症发生率。

Objective:To analyze the value of high virtual thread drainage and three space drainage in resection of high perianal abscess.Method:A total of 102 patients with high perianal abscess treated in Jiamusi Anorectal Hospital from February 2019 to November 2021 were selected as the research objects.According to the random number table method,they were divided into virtual thread drainage group and three space drainage group,with 51 cases in each group.High perianal abscess resection was performed in both groups,the virtual thread drainage group was treated with high virtual thread drainage,the three space drainage group was treated with three space drainage.The clinical efficacy,infection control time,wound healing time,overall hospital stay,anal function,pain factors and postoperative adverse reactions were compared between the two groups.Result:The total effective rate of the virtual thread drainage group(92.16%)was significantly higher than that of the three space drainage group(76.47%)(P<0.05).At 1 month and 2 months after operation,the anal resting pressure and the maximum anal systolic pressure in both groups decreased,and the Wexner score increased,the anal resting pressure and the maximum anal systolic pressure in the virtual thread drainage group were still higher than those in the three space drainage group,and the Wexner score was lower than that in the three space drainage group,the differences were statistically significant(P<0.05).3 d after operation,5-HT,SP and NE decreased in both groups,and those of the virtual thread drainage group were significantly lower than those of the three space drainage group(P<0.05).The infection control time,wound healing time and hospitalization time in the virtual thread drainage group were significantly shorter than those in the three space drainage group(P<0.05).The incidence of adverse reactions in the virtual thread drainage group was significantly lower than that in the three space drainage group(P<0.05).Conclusion:High virtual thread drainage and three space drainage have good therapeutic effects,but compared with three space drainage,high virtual thread drainage in the treatment of high perianal abscess has less damage to anal function,can inhibit the generation of pain factors,accelerate the recovery rate,and reduce the incidence of postoperative complications.