间断弧形切口手术治疗复杂性肛周脓肿的临床研究

Clinical Study of Interrupted Arc-Shaped Incision for Operative Treatment of Complex Perianal Abscess

目的:探讨间断弧形切口手术治疗复杂性肛周脓肿的临床效果。方法:将120例拟接受手术治疗的复杂性肛周脓肿患者随机分为观察组和对照组,各60例,观察组术中采用间断弧形切口,对照组术中采用放射状切口,比较2组患者创面愈合时间、术后后遗肛瘘情况、手术前后肛门测压结果及瘢痕大小。结果:2组手术时间及治愈率比较差异无统计学意义,P>0.05。观察组术后第7天肛门VAS评分低于对照组,P<0.05。观察组创面愈合时间[(19.38±3.49) d]短于对照组[(22.59±4.35) d],P<0.05。术后随访1年,观察组后遗肛瘘发生率(5.00%)低于对照组(8.33%),P<0.05。2组术前肛管静息压、肛管最大收缩压比较差异均无统计学意义,P>0.05;术后3个月2组肛管静息压和肛管最大收缩压较术前均降低,其中观察组降低幅度更小,组间比较,观察组肛管静息压和肛管最大收缩压高于对照组,P<0.05。观察组瘢痕评分(5.26±1.24)低于对照组(9.07 2.27),P<0.05。结论:与放射状切口相比,间断弧形切口手术治疗复杂性肛周脓肿创面愈合时间短,瘢痕小,后遗肛瘘发生率低,效果更好。

Objective To investigate the clinical effect of interrupted arc-shaped incision in the operative treatment of complex perianal abscess.Methods Total 120o patients with complex perianal abscess to be treated surgically were randomly divided into the observation group and the control group,60 cases in each group.Intermittent arc-shaped incision was used in the observation group and radial incision was used in the control group.The wound healing time,postoperative anal fistula,anal pressure measurement results before and after operation and scar size were compared between the two groups.ResultsThere was no significant difference in operation time and cure rate between the two groups(P>0.05).The anal VAS score of the observation group was lower than that of the control group on the 7th day after operation(P<0.05).The wound healing time of the observation group[(19.38±3.49)d] was shorter than that of the control group[(22.59±4.35)d](P<0.05).The incidence of postoperative anal fistula in the observa-tion group(5.00%)was lower than that in the control group(8.33%)(P<0.05).There was no statisti-cal significance in the preoperative resting pressure and maximum systolic pressure of anal canal between the two groups(P>0.05).Three months after operation,the resting pressure and maximum systolic pressure of anal canal in both groups were decreased compared with those before operation,and the de-crease in the observation group was smaller.Compared between groups,the resting pressure and maxi-mum systolic pressure of anal canal in the observation group were higher than those in the control group(P<0.05).The scar score of the observation group(5.26±1.24)was lower than that of the control group(9.07±2.27)(P<0.05).Conclusion Compared with radial incision,intermittent arc-shaped in-cision is more effective in the treatment of complex perianal abscess with shorter wound healing time,less scar and lower incidence of sequelae anal fistulas.