一次性切开根治术对肛周脓肿患者肛门功能恢复情况的影响

Effect of One-time Incision Radical Operation on the Recovery of Anal Function in Patients with Perianal Abscess

目的:探讨肛周脓肿行一次性切开根治术治疗的效果,分析对患者肛门功能恢复情况的影响。方法:选取2018年2月-2019年8月重庆市第九人民医院收治的108例肛周脓肿患者,应用单双号法将患者分为传统组和观察组,每组54例。传统组给予传统分期手术治疗,观察组行一次性切开根治术。比较两组术前和术后1、3、5 d的肛门疼痛评分;比较两组手术指标和创面恢复情况、肛门功能、肛门直肠测压、并发症和术后1年复发情况。结果:术前,两组视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05)。术后1、3、5 d,两组VAS评分均低于术前,且观察组均低于传统组,差异均有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05)。观察组住院时间、创面愈合时间均短于传统组,术中出血量少于传统组,术后2周创面缩小率高于传统组,差异均有统计学意义(P<0.05)。术后3个月和术后1年,观察组Wexner评分均低于传统组,差异均有统计学意义(P<0.05)。术后3个月,观察组肛管静息压和肛管最大收缩压均高于传统组(P<0.05)。术后1年,观察组肛管静息压、直肠静息压和肛管最大收缩压均高于传统组,差异均有统计学意义(P<0.05)。观察组并发症发生率低于传统组,差异有统计学意义(P<0.05)。两组复发率比较,差异无统计学意义(P>0.05)。结论:一次性切开根治术可有效缓解肛周脓肿患者肛门疼痛程度,保护肛门功能,促进恢复,减少并发症,临床治疗安全性提高。

Objective:To investigate the effect of one-time incision radical operation for perianal abscess,and analyze the influence on the recovery of anal function.Method:A total of 108 patients with perianal abscess admitted to the Ninth People’s Hospital of Chongqing from February 2018 to August 2019 were selected,they were divided into traditional group and observation group by odd and even number method,with 54 cases in each group.The traditional group was treated with traditional staged operation,and the observation group was treated with onetime incision radical operation.The anal pain scores before operation and 1,3,and 5 d after operation were compared between the two group;the surgical indicators,wound recovery,anal function,anorectal manometry,complications and recurrence 1 year after operation were compared between the two groups.Result:Before operation,there was no significant difference in visual analogue scale(VAS)score between the two groups(P>0.05).At 1,3,and 5 d after operation,the VAS scores of both groups were lower than those before operation,those of the observation group were lower than those of the traditional group,the differences were statistically significant(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).The hospitalization time and wound healing time of the observation group were shorter than those of the traditional group,the intraoperative blood loss of the observation group was less than that of the traditional group,the wound reduction rate at 2 weeks after operation of the observation group was higher than that of the traditional group,the differences were statistically significant(P<0.05).3 months and 1 year after operation,the Wexner scores of the observation group were lower than those of the traditional group,the differences were statistically significant(P<0.05).3 months after operation,anal resting pressure and anal maximum systolic pressure of the observation group were higher than those of the traditional group(P<0.05).1 year after operation,anal resting pressure,rectal resting pressure and anal maximum systolic pressure of the observation group were higher than those of the traditional group,the differences were statistically significant(P<0.05).The complication rate of the observation group was lower than that of the traditional group,the difference was statistically significant(P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion:One-time incision radical operation can effectively relieve anal pain in patients with perianal abscess,protect anal function,promote recovery,reduce complications,and improve the safety of clinical treatment.