肛瘘或肛周脓肿合并糖尿病患者的药物联合手术治疗方法及效果探讨

Discussion on the method and effect of combined drug and surgery treatment for patients with anal fistula or perianal abscess complicated with diabetes

目的 探讨肛瘘或肛周脓肿合并糖尿病患者药物联合手术治疗的方法及效果。方法 60例肛瘘或肛周脓肿合并糖尿病患者,所有患者均接受手术治疗,术前予以胰岛素对血糖进行控制确保其稳定降低,并合理控制饮食,待血糖稳定后再实施手术。术后完善抗感染、创面换药及并发症预防。术后随访3个月,分析患者治疗效果;比较不同创口直径患者的创口渗液时间、创口愈合时间,手术前后静息、走路、换药时创面疼痛评分及睡眠障碍评分。结果 术后随访3个月, 60例患者中显效40例(66.67%),有效18例(30.00%),无效2例(3.33%),治疗总有效率为96.67%。随着创口直径的增加,创口渗液时间、创口愈合时间均出现延长,不同创口直径患者的创口渗液时间、创口愈合时间比较差异具有统计学意义(P<0.05)。术后3 d、1周、2周,患者静息、走路、换药时创面疼痛评分及睡眠障碍评分均低于手术前(P<0.05)。结论 对肛瘘或肛周脓肿并合糖尿病患者给予药物联合手术治疗效果理想,手术切口越小,越有利于切口愈合。

Objective To explore the method and effect of combined drug and surgery treatment for patients with anal fistula or perianal abscess complicated with diabetes.Methods All 60 patients with anal fistula or perianal abscess complicated with diabetes received surgical treatment.Before surgery,insulin was given to control blood glucose and ensure its stable reduction,and reasonable control of diet,and then surgery was carried out after the stabilization of blood glucose.After surgery,anti-infection,wound dressing change and complication prevention were improved.The patients were followed up for 3 months after surgery to analyze the treatment effect.Comparison was made on wound oozing time and wound healing time of patients with different wound diameters,as well as the wound pain scores and sleep disorder scores at rest,walking and dressing change before and after surgery.Results After 3 months of follow-up,40 patients(66.67%)were significantly effective,18 patients(30.00%)were effective,and 2 patients(3.33%)were ineffective.The total effective rate was 96.67%.With the increase of wound diameter,wound oozing time and wound healing time appeared to be prolonged,and the difference in the comparison of wound oozing time and wound healing time of patients with different wound diameters was statistically significant(P<0.05).At 3 d,1 week and 2 weeks after surgery,the wound pain scores and sleep disorder scores of patients at rest,walking and dressing change were lower than those before surgery(P<0.05).Conclusion For patients with anal fistula or perianal abscess complicated with diabetes,the effect of combined drug and surgery treatment is ideal.The smaller the surgical incision,the more beneficial the incision healing.