LIFT治疗复杂肛瘘疗效与切开挂线术疗效对比研究

Comparative curative effect study of the LIFT and incision-thread-drawing procedure in the treatment of complex anal fistula

目的探讨括约肌间瘘管结扎术(LIFT)治疗复杂肛瘘的疗效,并与切开挂线术疗效进行对比。方法选择2014年1月至2015年6月我院收治的复杂肛瘘患者64例,按手术方式不同随机分为观察组和对照组,各32例。分别给予LIFT、切开挂线术。对比两组患者手术用时、术中出血量、疼痛时间、住院时间、创伤面积、创伤愈合时间;对比两组患者并发症发生率;随访1年,对比两组患者不同随访时间Wexner肛门失禁评分;对比两组治疗总有效率、治疗满意率。结果观察组患者术中出血量较对照组少,疼痛时间、住院时间、创伤愈合时间均较对照组短,创伤面积较对照组小;观察组并发症发生率(12.50%)较对照组(31.25%)低;观察组术后1个月起无肛门失禁,术后各随访时间点肛门失禁评分均低于对照组;观察组治疗总有效率(94.88%)较对照组高(84.38%);观察组患者对治疗的满意率(93.75%)较对照组高(78.13%)(均P<0.05)。结论 LIFT治疗复杂肛瘘具有创伤小、疼痛时间短、创面愈合快等优点,术后并发症少,肛门失禁可较快解决,疗效较好,值得临床推广。

Objective To investigate LIFT curative effect in treatment of complex anal fistula, and compare the treatment efficacy with incision-thread-drawing procedure. Methods Selected 64 cases complex anal fistula from January 2014 to June 2015 as the research object, according to the type of surgery, the patients were randomly divided into the observation group and the control group with the treatment of LIFT and incision-thread-drawing procedure respectively. The operation time, the blood loss, the time of pain, hospitalization time, wound area, wound healing time, the incidence of complications were compared between two groups. The patients were followed up for 1 year, Wexner anal incontinence scores, total treatment efficiency and treatment satisfaction rate were compared between two groups of patients. Results In the observation group, the intraoperative bleeding volume was less than that of the control group, the time of pain,hospitalization time, wound healing time were shorter than those in the control group, wound area was smaller than that in the control group, the incidence rate of complications(12.50%) was lower than that in the control group(31.25%). After 1month of the operation, the observation group has no anal incontinence, anal incontinence scores at each follow-up time point postoperative were lower than control group. The total efficiency of the observation group(94.88%) was higher than that in control group(84.38%). The treatment satisfaction rate of observation group(93.75%) was higher than that in the control group of 78.13%(P <0.05). Conclusion LIFT treatment of complex anal fistula has the advantage of small trauma,short pain time, fast wound healing, less complications, good curative effect, which is worth promoting.