病灶清除联合皮瓣转移及植皮术治疗肛周化脓性汗腺炎疗效观察

Clinical Efficacy of Lesion Removal Combined with Skin Flap Transfer and Skin Grafting in Treatment of Perianal Suppurative Hidradenitis

目的:探讨病灶清除联合皮瓣转移及植皮术治疗肛周化脓性汗腺炎的临床疗效及安全性。方法:选取2023年2~8月,本院诊治的60例Hurley-Ⅱ期以上肛周化脓性大汗腺炎患者,随机分为A、B、C组,每组各20例。A组采用单纯切开引流术治疗,B组行病灶清除联合皮瓣转移术治疗,C组行病灶清除联合皮瓣转移及植皮术治疗。观察比较3组疗效、手术时间、术后生活质量及并发症等指标。结果:B组和C组治愈率均明显高于A组(P<0.05),B组和C组治愈率比较,差异无统计学意义(P>0.05)。C组术后生活质量评分及费用明显高于A组和B组(P<0.05),术后并发症发生率少于A组和B组(P<0.05),3组创面愈合时间比较差异无统计学意义(P>0.05)。预后不仅与手术方式、病变程度、医师技术水平有关,还与家族遗传病史,合并免疫疾病、感染、肥胖和吸烟有关(P<0.05)。结论:病灶清除联合皮瓣转移及植皮术治疗肛周化脓性汗腺炎复发率低,并发症少,术后生活质量高,值得临床推广应用。

Objective To investigate the clinical efficacy and safety of lesion removal combined with skin flap transfer and skin grafting in the treatment of perianal suppurative hidradenitis.Methods From February to August 2023,total 60 patients with perianal suppurative aphidradenitis in Hurley-Ⅱstage and above were selected and randomly divided into groups A,B and C,with 20 cases in each group.The group A was treated with simple incision and drainage.The group B was given lesion removal combined with skin flap transfer,and the group C received lesion removal combined with skin flap transfer and skin grafting.The efficacy,operation time,postoperative quality of life and complications of the three groups were observed and compared.Results The cure rate of the group B and group C was significantly higher than that of the group A(P<0.05),but there was no significant difference between the group B and group C(P>0.05).The postoperative quality of life score and cost of the group C were significantly higher than those of the group A and group B(P<0.05),the incidence of postoperative complications was lower than that of group A and group B(P<0.05),and there was no statistical significance in wound healing time between the three groups(P>0.05).The prognosis was not only related to the surgical method,the degree of lesion and the skill level of doctors,but also related to family genetic history,combined immune disease,infection,obesity and smoking(P<0.05).Conclusion The treatment of perianal suppurative hidradenitis with lesion removal combined with skin flap transfer and skin grafting has low recurrence rate,few complications and high postoperative life quality,which is worthy of clinical application.