输尿管细镜引导下肛瘘钬激光切除术治疗肛瘘的临床研究

Clinical study of holmium laser resection of anal fistula guided by ureteroscope

目的:观察输尿管细镜引导下肛瘘钬激光切除术治疗肛瘘的临床疗效。方法:将新建区人民医院2020年7月—2021年7月肛肠科收治的50例低位经括约肌肛瘘患者随机分为治疗组(25例)和对照组(25例)。治疗组采用输尿管细镜引导下肛瘘钬激光切除术治疗,对照组采用肛瘘切开术治疗。对比两组临床疗效、术后肛门功能评分、术后疼痛评分、创面分泌物情况、创面愈合时间及术后复发率。结果:治疗组有效治愈率为92%,对照组为88%(P>0.05);治疗组术后肛门疼痛、创面分泌物评分低于对照组,肛门功能评分优于对照组,创面愈合时间短于对照组,复发率低于对照组(P<0.05)。结论:采用输尿管细镜引导下肛瘘钬激光切除术治疗低位经括约肌肛瘘患者疗效满意,术后具有愈合快、疼痛轻、分泌物少、微创、复发率低等优点。

Objective : To observe the clinical effect of ureteroscopic guided holmium laser resection of anal fistula.Methods : Fifty patients with low sphincter anal fistula admitted to the department of anorectal surgery of Xinjian District People’s Hospital from July 2020 to July 2021 were randomly divided into treatment group(25 cases) and control group(25 cases). The treatment group was treated by resection of anal fistula under the guidance of ureteroscope, while the control group was treated by incision of anal fistula. The clinical effects, postoperative anal function score, secretion, wound healing time and postoperative recurrence incidence of the two groups were compared. Results : The effective cure rate was 92% in the treatment group and 88% in the control group(P>0. 05). Postoperative anal pain and wound secretion scores in the treatment group were lower than those in the control group;anal function score was better than that of the control group;wound healing time was shorter than that of the control group;recurrence incidence was lower than that of the control group(P<0. 05). Conclusion : The treatment of low post sphincter anal fistula with ureteroscopy guided anal fistula resection is satisfactory. It has the advantages of fast healing, light pain, less secretion, minimally invasive and low recurrence rate.