改良切口引流结合挂线术治疗高位复杂性肛瘘患者的效果分析

Analysis of the Effect of Modified Incision Drainage Combined with Hanging Wire Surgery in Treating Patients with High Complex Anal Fistula

目的 分析改良切口引流+挂线术治疗高位复杂性肛瘘(high complex anal fistula, HCAF)的临床效果。方法 方便选取2021年1月—2023年6月邳州市中医院收治的76例HCAF患者为研究对象,用随机数表法分为对照组和观察组,各38例。对照组行常规挂线术治疗,观察组行改良切口引流+挂线术治疗。比较两组患者围术期指标、疼痛程度、并发症、肛门功能及生活功能评分。结果 观察组瘢痕面积小于对照组,创面愈合、住院时间短于对照组,差异有统计学意义(P<0.05)。观察组术后1、7、14 d疼痛评分分别为(4.21±0.71)、(2.41±0.65)、(2.02±0.27)分低于对照组,差异有统计学意义(t=4.665、6.568、3.325,P<0.05)。观察组并发症总发生率5.26%低于对照组,差异有统计学意义(χ^(2)=5.208,P<0.05)。术后,观察组肛门功能评分低于对照组,生活功能评分高于对照组,差异有统计学意义(P<0.05)。结论 予以HCAF患者改良切口引流+挂线术治疗疼痛较轻,可改善患者肛门功能,提高患者生活质量,并发症少,促进患者术后恢复。

Objective To analyze the clinical effect of modified incision drainage+hanging wire surgery for the treat-ment of high complex anal fistula(HCAF).Methods 76 patients with HCAF admitted to Pizhou Hospital of Traditional Chinese Medicine from January 2021 to June 2023 were conveniently selected as the study objects.They were divided into the control group and the observation group according to the random number table,with 38 cases in each group.The patients of the control group were treated with conventional hanging wire surgery,and the patients of the observa-tion group were treated with modified incision drainage+hanging wire surgery.Perioperative indicators,pain level,complications,anal function and life function scores were compared between the two groups.Results The observation group had smaller scar area,shorter wound healing and hospitalization time than the control group,and the differences were statistically significant(P<0.05).The postoperative pain scores of 1,7,and 14 d in the observation group were(4.21±0.71),(2.41±0.65)and(2.02±0.27)points,which were lower than those in the control group,and the differences were statistically significant(t=4.665,6.568,3.325,P<0.05).The complication rate of 5.26%in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=5.208,P<0.05).After sur-gery,the observation group had lower anal function scores and higher life function scores than the control group,and the differences were statistically significant(P<0.05).Conclusion The modified incisional drainage+hanging wire sur-gery for patients with HCAF is less painful,can improve patients'anal function,improve patients'quality of life,has fewer complications,promotes patients'postoperative recovery.