联合术式治疗复杂性肛痿的临床疗效观察

Observation of clinical efficacy of combined operation in the treatment of complicated anal fistula

目的探讨联合术式治疗复杂性肛痿的临床疗效。方法选取2021年4月至2022年2月在普宁市人民医院胃肠外科接受治疗的复杂性肛痿患者60例为研究对象,按照随机数表法分成治疗组和对照组,每组各30例。治疗组采用联合术式,对照组采用肛瘘切除挂线术。观察两组手术指标、并发症、创面平均愈合时间、住院时间及临床疗效。随访6个月,观察两组肛门功能及复发情况。结果两组手术时间及术后排便时间比较,差异无统计学意义(P>0.05),治疗组术中出血量、术后疼痛视觉模拟评分明显低于对照组,差异有统计学意义(P<0.05)。治疗组创面愈合时间和住院时间明显短于对照组,差异有统计学意义(P<0.05)。治疗组术后出血发生率明显低于对照组,差异有统计学意义(P<0.05)。两组术后感染发生率及临床疗效比较,差异无统计学意义(P>0.05)。随访6个月,治疗组肛门失禁1例(3.33%),对照组肛门失禁5例(16.67%),治疗组肛门失禁发生率明显低于对照组,差异有统计学意义(χ^(2)=5.984,P=0.015)。两组术后复发率比较,差异无统计学意义(10.0%vs.10.0%,χ^(2)=0.000,P=1.000)。结论复杂性肛痿患者采用联合术式治疗,可明显缩短患者创面愈合时间、住院时间,有效恢复肛门功能。

Objective To observe the clinical efficacy of combined operation in the treatment of complicated anal fistula.Methods A total of 60 patients with complicated anal fistula who were treated in the Department of Gastrointestinal Surgery of Puning People’s Hospital from April 2021 to February 2022 were selected as the research objects.According to the random number table method,they were divided into the treatment group(n=30)and the control group(n=30).The treatment group was adopted with combined operation,while the control group was adopted with conventional anal fistula resection and thread drawing operation.The operation indices,complications,average wound healing time,hospitalization time and clinical efficacy of the two groups were observed.They were followed up for 6 months,and the anal function and relapse of the two groups were observed.Results There were no statistically significant differences in the operation duration and postoperative defecation time between the two groups(P>0.05).However,the intraoperative hemorrhage volume and postoperative visual analogue scale scores in the treatment group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The wound healing time and hospitalization time in the treatment group were significantly shorter than those in the control group,with statistically significant differences(P<0.05).The incidence of postoperative hemorrhage in the treatment group was significantly lower than that in the control group,with statistically significant difference(P<0.05).There were no statistically significant differences in the incidence of postoperative infection and clinical efficacy between the two groups(P>0.05).After 6 months’follow-up,there was 1 case of anal incontinence in the treatment group(3.33%)and 5 cases of anal incontinence in the control group(16.67%).The incidence of anal incontinence in the treatment group was significantly lower than that in the control group,with statistically significant difference(χ^(2)=5.984,P=0.015).There was no statistically significant difference in postoperative relapse rate between the two groups(10.0%vs.10.0%,χ^(2)=0.000,P=1.000).Conclusion Combined operation for complicated anal fistula can obviously shorten the wound healing time and hospitalization time of patients,and effectively restore their anal function.