药线双挂法治疗肛周脓肿的临床疗效观察

Clinical efficacy of medication wire double-hanging method in treating perianal abscess

目的观察药线双挂法治疗肛周脓肿的临床疗效。方法选择江西中医药大学附属医院肛肠科2021年6月至2022年6月收治的36例肛周脓肿患者为研究对象,按随机数字表法分为观察组(n=18,采用药线双挂法治疗)和对照组(n=18,采用肛周脓肿切开引流术治疗)。比较两组临床疗效、术后恢复相关指标、创面症状评分(包括创面疼痛、创面渗液、肉芽生长情况及创面水肿)、生长因子表达水平(b FGF、VEGF)及肛门功能。结果观察组治愈16例,治疗总有效比例为16/18,对照组治愈9例,总有效比例为9/18,两组比较差异有统计学意义(P<0.05)。观察组创面愈合时间短于对照组(P<0.05),两组住院时间比较差异无统计学意义(P>0.05)。术后3个月,观察组有2例(2/18)形成肛瘘,对照组有9例(9/18)形成肛瘘,观察组成瘘比例低于对照组(P=0.027)。术后第1天,两组创面疼痛、创面渗液、肉芽生长情况、创面水肿程度评分比较差异均无统计学意义(均P>0.05);术后第14天,两组创面疼痛、创面渗液、肉芽生长情况、创面水肿程度评分均低于术后第1天,且观察组创面疼痛、肉芽生长情况、创面水肿程度评分均低于对照组,而创面渗液评分高于对照组(均P<0.05)。术前,两组肛周组织b FGF、VEGF表达水平比较差异均无统计学意义(均P>0.05);术后第14天,两组创面组织b FGF、VEGF表达水平均高于术前,且观察组均高于对照组(均P<0.05)。术前,两组肛管静息压和肛管最大收缩压比较差异均无统计学意义(均P>0.05);术后3个月,观察组肛管静息压和肛管最大收缩压与术前比较差异均无统计学意义(均P>0.05),对照组肛管静息压和肛管最大收缩压均低于术前,观察组肛管静息压和肛管最大收缩压均高于对照组(均P<0.05)。结论药线双挂法治疗肛周脓肿具有良好的临床疗效,能够促进创面渗液渗出和肉芽生长,减轻创面疼痛和水肿程度,有利于保护患者肛门功能。

Objectives To observe the clinical efficacy of the medication wire double-hanging method in treating perianal ab⁃scess.Methods A total of 36 patients with perianal abscess admitted to the Department of Gastroenterology,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from June 2021 to June 2022 were selected as the research subjects.They were randomly divided into an observation group(n=18,treated with the medication wire double-hanging method)and a control group(n=18,treated with perianal abscess incision and drainage).The clinical efficacy,postoperative recovery-related indicators,wound symptom scores(wound pain,wound exudation,granulation growth,wound swelling),expression levels of growth factors(bF⁃GF,VEGF),and anal function were compared between the two groups.Results In the observation group,16 patients were cured,with a total effective rate of 16/18;in the control group,9 patients were cured,with a total effective rate of 9/18.The difference between the two groups was statistically significant(P<0.05).Wound healing in the observation group was shorter than that in the control group(P<0.05).There was no statistically significant difference in hospital stay between the two groups(P>0.05).Three months after surgery,2 patients(2/18)in the observation group formed fistulas,while 9 patients(9/18)in the con⁃trol group formed fistulas.The fistula formation rate in the observation group was lower than that in the control group(P=0.027).On the first day after surgery,there was no statistically significant difference in wound pain,wound exudation,granulation growth,and wound swelling between the two groups(P>0.05);on the fourteenth day after surgery,the scores for wound pain,granulation growth,and wound swelling were lower in the observation group than in the control group,while the score for wound exudation was higher in the observation group than in the control group(P<0.05).Before surgery,there was no statistically signifi⁃cant difference in the expression levels of bFGF and VEGF in perianal tissue between the two groups(P>0.05);on the fourteenth day after surgery,the expression levels of bFGF and VEGF in the wound tissue were higher than those before surgery in both groups,and the levels were higher in the observation group than in the control group(P<0.05).Before surgery,there was no statisti⁃cally significant difference in anal resting pressure and maximum anal squeezing pressure between the two groups(P>0.05);three months after surgery,there was no statistically significant difference in anal resting pressure and maximum anal squeezing pres⁃sure compared to before surgery in the observation group(P>0.05),while in the control group,anal resting pressure and maxi⁃mum anal squeezing pressure were higher than before surgery,and the anal resting pressure and maximum anal squeezing pres⁃sure in the observation group were higher than those in the control group(P<0.05).Conclusion The medication wire doublehanging method proves effective in treating perianal abscess.It promotes wound exudation and granulation growth,reduces wound pain and swelling,and is beneficial to protect the anal function of patients.