低位实挂线高位虚实结合挂线法治疗高位肛瘘的临床效果

Comparative clinical study on treating high anal fistula with low solid thread-ligating therapy and high with combination of dotted and solid thread-ligating therapy and traditional solid thread-ligating therapy

目的:比较低位实挂线高位虚实结合挂线法治疗高位肛瘘的临床疗效。方法:选取山西省临汾市中心医院肛肠外科2020年6月—2022年1月收治的72例高位肛瘘患者,按治疗方法不同分为观察组与对照组,每组36例。观察组采用低位实挂线高位虚实结合挂线法治疗,对照组采用传统切开挂线法治疗。比较两组患者术后疼痛评分、创面愈合时间、肛门功能及有效率。结果:观察组术后第7天及第10天疼痛VAS评分为(2.64±0.64)分和(1.56±0.65)分,分别低于对照组的(3.08±0.90)分和(1.94±0.71)分,差异有统计学意义(P<0.05);观察组术后第3个月及第6个月的Wexner评分为(3.17±0.85)分和(2.14±0.68)分,分别低于对照组的(3.75±0.84)分和(2.72±0.70)分,差异有统计学意义(P<0.05);观察组愈合时间为(25.78±2.87)d,短于对照组的(33.36±3.46)d,差异有统计学意义(P<0.05)。结论:低位实挂线高位虚实结合挂线法治疗高位肛瘘的临床疗效较好,创面愈合所需时间更短,远期肛门功能保护的更好。

Objective To compare the clinical effect of treating high anal fistula with solid thread-ligating therapy and combination of dotted and solid thread-ligating therapy.Methods 72 patients with high anal fistula were recruited from our hospital between June 2020 and January 2022.Patients were randomly assigned to treatment group and control group,with 36 patients in each group.Patients in the treatment group was treated with combination of dotted and solid thread-ligating therapy,and the control group was treated with the traditional seton.The postoperative pain score,wound healing time,anal function,effective rate were compared between the two groups.Results The VAS scores of pain in the observation group(2.64±0.64)and(1.56±0.65)on the 7th and 10th days after operation were significantly lower than those in the control group(3.08±0.90)and(1.94±0.71)(P<0.05).The scores of Wexner(3.17±0.85)and Wexner(2.14±0.68)in the observation group were lower than those of the control group(3.75±0.84)and Wexner(2.72±0.70)at 3rd month and 6th month after operation,and the difference was statistically significant(P<0.05);The healing time of the observation group(25.78±2.87)days was shorter than that of the control group(33.36±3.46)days,with a statistically significant difference(P<0.05).Conclusion The combination of dotted and solid thread-ligating therapy has the advantages of faster wound healing and better anal function protection.