括约肌间瘘管结扎术联合瘘管隧道式切除术治疗低位肛瘘患者的效果

Effects of ligation of intersphincteric fistula tract combined with fistula tunnel resection in treatment of patients with low anal fistula

目的:观察括约肌间瘘管结扎术联合瘘管隧道式切除术治疗低位肛瘘患者的效果。方法:回顾性分析2020年1月至2022年12月该院收治的80例低位肛瘘患者的临床资料,依据治疗方法不同将其分为对照组和观察组各40例。对照组采用瘘管切开术治疗,观察组采用括约肌间瘘管结扎术联合瘘管隧道式切除术治疗。比较两组临床相关指标[创面愈合时间、住院时间、术后肛门疼痛程度(视觉模拟评分法(VAS)评分)]水平,手术前后肛门失禁Wexner评分和术后并发症发生率。结果:观察组创面愈合时间、住院时间均短于对照组,VSA评分低于对照组,差异有统计学意义(P<0.05);术后1、3个月,观察组肛门失禁Wexner评分均低于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:括约肌间瘘管结扎术联合瘘管隧道式切除术治疗低位肛瘘患者可缩短创面愈合时间和住院时间,降低术后VAS评分和肛门失禁Wexner评分,其效果优于瘘管切开术治疗。

Objective:To observe effects of ligation of intersphincteric fistula tract combined with fistula tunnel resection in treatment of patients with low anal fistula.Methods:The clinical data of 80 patients with low anal fistula admitted to this hospital from January 2020 to December 2022 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,40 cases in each.The control group was treated with fistulotomy,while the observation group was treated with ligation of intersphincteric fistula tract combined with fistula tunnel resection.The levels of clinical related indicators[wound healing time,hospitalization time,anal pain score after the surgery visual analogue scale(VAS)],the Wexner scores of anal incontinence before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:The wound healing time and the hospitalization time of the observation group were shorter than those of the control group,the VAS scores was lower than that of the control group,and the differences were statistically significant(P<0.05).1 and 3 months after the surgery,the Wexner scores of anal incontinence in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions:Intersphincteric fistula ligation tract combined with fistula tunnel resection in the treatment of the patients with low anal fistula can shorten the wound healing time and the hospitalization time and reduce the postoperative VAS scores after the surgery and the Wexner score of anal incontinence.Moreover,it is superior to fistulotomy.