复杂性肛瘘实施保留外括约肌TROPIS的疼痛及并发症情况分析

Analysis of pain and complications in the implementation of external sphincter preservation TROPIS for complex anal fistulas

目的探究复杂性肛瘘患者行肛括约肌间切开术(TROPIS)的临床疗效.方法择取靖边县人民医院2022年3月-2023年10月收治的80例复杂性肛瘘患者作为研究对象,依据随机数字表法分组(对照组:括约肌间瘘管结扎术,观察组:保留外括约肌经肛括约肌间切开术),每组40例,对比两组疼痛应激指标、肛管压力、Wexner肛门失禁评分、并发症发生率.结果观察组术后7d疼痛应激指标水平低于对照组(P<0.05);观察组术后3个月30mm肛管压力低于对照组(P<0.05);观察组术后1个月、3个月Wexner肛门失禁评分低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05).结论在对复杂性肛瘘患者治疗时,TROPIS术疼痛应激反应更轻,术后并发症少,值得推广.

Objective To explore the clinical efficacy of anal sphincterotomy(TROPIS)in patients with complex anal fistula.Methods 80 patients with complex anal fistula admitted to our hospital from March 2022 to October 2023 were selected as the study subjects.They were randomly divided into two groups using a random number table method(control group:ligation of the anal sphincter fistula,observation group:preservation of the external sphincter through the anal sphincter incision).Forty patients in each group were compared in terms of pian stress indicators,anal pressure,Wexner anal incontinence scores,and incidence of complications between the two groups.Results The level of pain stress indicators in the observation group was lower than that in the control group 7 days after surgery(P<0.05);the anal pressure in the observation group was lower than that in the control group at 30 mm after 3 months of surgery(P<0.05);the Wexner anal incontinence score in the observation group was lower than control group(P<0.05)at 1 and 3 months after surgery;the incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion In the treatment of patients with complex anal fistula,TROPIS surgery has a lighter pain stress response and fewer postoperative complications,which can be worth promoting.