肛门直肠周围脓肿一期手术的临床疗效观察

The clinic effect observation of one stage radical resection on perianorectal abscess

目的 观察和评估一期根治术治疗肛门直肠周围脓肿的临床疗效。方法 将252例肛门直肠周围脓肿病例随机分成两组 :一期根治性切开术组(PCID组) ,和单纯切开引流术组(TID组)。观察2组病例术后感染控制情况 ,创面愈合时间 ,随访术后3年内的脓肿复发和肛瘘发生情况。结果 PCID组病例术后感染控制时间(5±3)d较TID组(7±4)d明显缩短(p<0.05) ;PCID组术后脓肿复发需再次手术3例 ,较TID组24例明显减少(p<0.01) ;PCID组术后后遗肛瘘4例 ,较TID组58例明显减少(p<0.01)。结论 一期根治手术治疗肛门直肠周围脓肿较单纯切开引流手术存在优越性 ,能明显缩短术后感染控制时间 ,降低术后脓肿的复发率和肛瘘的发生率 ,缩短病程等 ,是治疗肛门直肠周围脓肿的首选方法。

Objective To explore the clinic treatment effect of one stage radical resection on perianorectal abscess. Methods 252cases of perianorectal abscess were randomly divided into2groups:one stage radical resection(OSRR)group and simple incision and drainage(SID)group.The cases of2groups were observed on their postoperative infection control condition,incision healing time,abscess relapse and anal fistula incidence by folˉlowing-up3year after operation. Results The postoperative infection control time of OSRR group(5±3d)was significantly less than that of SID group(7±4d)(p<0.05).The number of reoperation because of abscess relapse postoperative in OSRR group(n=3)was significantly less than that of SID group(n=24)(p<0.01).The number of anal fistula postoperative in OSRR group(n=4)was significantly less than that of SID group(n=58)(p<0.01). Conclusion OSRR on perianorectal abscess is obvious superior to SID.OSRR has many virtue such as less postoperative infection control time,less incidence of abscess relapse and anal fistula postoperative,shorter course,and so on,therefore OSRR is the best option in perianorectal abscess treatment.