A case study illustrating the use of an integrated approach to treat secondary Anal Fistula Post I&D of Perianal Abscess

Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach.

Clinical Study on the Effectiveness of Xian Fang Huo Ming Yin for Treating Cutaneous Infections and Promoting Wound Healing in Patients with Perianal Abscess

Objective:To explore the effect of the Xian Fang Huo Ming Yin(XFHM)for treating cutaneous infections and promoting wound healing in patients with perianal abscesses.Methods:Sixty-one patients with perianal abscesses who were admitted to our hospital(Xinghua City People’s Hospital)from May 2022 to May 2023 were selected and randomly divided into two groups,a control group(30 cases)and a study group(31 cases).Both groups received surgical treatment.The control group received conventional treatment and warm water fumigation,sitz bath,and surgical dressing change after surgery,while the research group received XFHM based on the control group.XFHM was taken orally and replaced with warm water for fumigation and sitz bathing.Both groups received treatment for 4 weeks but discontinued sitz bathing after 2 weeks.Various clinical indicators between the two groups were compared.Results:The total clinical effective rate and wound recovery rate of the study group were higher than that of the control group.There were differences in the wound pain scores,surrounding tissue edema,and wound secretions at different time points.Both groups experienced wound pain.The scores of wound pain,surrounding tissue edema,and wound secretions of the study group were lower than those of the control group,7 and 14 days after surgery.The serum interleukin 6(IL-6),tumor necrosis factor-alpha(TNF-α)levels,and pH values of the study group were lower than those of the control group 10 days after surgery(P<0.05).Conclusion:The application of XFHM for treating cutaneous infections and promoting wound healing in patients with perianal abscesses improved the treatment outcome,alleviated clinical symptoms,and promoted healing.

Suspected coexistence of perianal necrotizing sweet syndrome in chronic myelomonocytic leukemia:A case report

BACKGROUND Chronic myelomonocytic leukemia(CMML)complicated with Sweet syndrome(SS)is a rare hematological neoplasm.However,cases of concomitant development of perianal necrotizing SS(NSS)have not been reported.CASE SUMMARY We report a case of a 49-year-old male patient who underwent sequential procedures for hemorrhoids and perianal abscess.He developed postoperative incision infection and was referred to the department where the authors work.Initially,perianal necrotizing fasciitis secondary to incision infection after perianal abscess surgery was suspected.Despite receiving antibiotic therapy and undergoing surgical debridement,deeper necrotic areas formed in the patient’s perianal wounds,accompanied by persistent high fever.Blood and fungal cultures yielded negative results.The final diagnosis was corrected to be CMML with suspected concomitant perianal NSS.CONCLUSION CMML with perianal NSS is a rare condition,often misdiagnosed as perianal abscess or perianal necrotizing fasciitis.Conventional antibiotic therapy and surgical debridement are ineffective in managing this condition.

Application of Three-Dimensional Magnetic Resonance Imaging in the Diagnosis of Perianal Abscess

Perianal abscess is a common disease in anorectal surgery. If the diagnosis is not clear and the cure is thoroughly cleared, the recurrence and spread of anal fistula will cause life-long pain. Objective: To investigate the application of 3.0T MRI 3D CUBE T2WI lipid suppression sequence in the diagnosis of perianal abscess. Methods: Thirty-six patients with perianal abscess confirmed by operation were examined with 2D T2WI and 3D CUBE T2WI lipid suppression sequences before operation. Two imaging techniques were evaluated to show the types of perianal abscess, the number of abscesses, the number of internal orifices of abscess, and the number of fistula branches with anal fistula in abscess. Results: Among 36 cases of perianal abscess, there were 5 cases of anal subcutaneous abscess, 12 cases of ischiorectal space abscess (8 cases complicated with anal fistula), 6 cases of posterior anal space abscess, 5 cases of anal sphincter abscess (3 cases complicated with anal fistula), 2 cases of high intermuscular abscess, 2 cases of rectal submucosal abscess, 3 cases of complex abscess (3 cases complicated with anal fistula), 1 case of misdiagnosis, 2D T2WI lipid suppression sequence and 3D CUBE T2WI suppression. The accuracy of lipid sequence abscess typing was 80.6% (29/36) and 88.9% (32/36), respectively, with no significant difference (P > 0.05). Thirty-six patients were surgically diagnosed as having 32 internal orifices, 68.8% (22/32) and 93.8% (30/32) of 2D T2WI and 3D CUBE T2WI lipid-suppressing sequences, respectively, with significant difference (P Conclusion: 3D CUBE T2WI lipid suppression sequence is superior to 2D T2WI lipid suppression sequence in the classification of perianal abscess, the number of internal orifices of abscess and the number of fistula branches of abscess complicated with anal fistula. It can also determine the number of internal orifices of abscess complicated with anal fistula, the number of fistula branches, the shape of primary and branch fistula and the relationship among pelvic floor muscle tissues. It can provide more accurate images for preoperative and intraoperative clinical surgery.

Extranodal natural killer/T-cell lymphoma(nasal type) presenting as a perianal abscess: A case report

BACKGROUND Extranodal natural killer(NK) T-cell lymphoma(ENKTL), nasal type is a rare subtype of extranodal non-Hodgkin lymphoma characterized by vascular damage and necrosis. The lesions usually present in the nasal cavity and adjacent tissues, however, the disease originates from the gastrointestinal or genitourinary tract in 25% of cases. Since rectal involvement in ENKTL is rare, rectal symptoms in the course of ENKTL are often misdiagnosed and considered to be related to benign diseases such as rectal fistula or perianal abscess.CASE SUMMARY We report the case of a 24-year-old Han Chinese female who initially presented with a perianal abscess that was subsequently diagnosed as nasal type ENKTL.Due to typical perianal pain, perianal abscess was diagnosed and surgical incision and drainage were performed. After recurrent, severe anal hemorrhages leading to hypovolemic shock and multiple surgeries, a diagnosis of ENKTL was made. The patient's condition gradually deteriorated, and she died shortly after initiation of chemotherapy.CONCLUSION Systemic and neoplastic diseases should be included in the differential diagnosis of any potentially benign perianal abscess complicated with recurrent hemorrhages.

A Review on Treating Postoperative Perianal Abscess by the TCM External Therapy

Perianal abscess is a common clinical disease.This disease progresses rapidly.Surgical treatment is the main clinical treatment.Postoperative pain,bleeding,and excessive exudate are often accompanied by slow postoperative wound healing due to special anatomic site.The external treatment of traditional Chinese medicine has various treatment methods for perianal abscess after operation,and the results are quite effective.The treatment experience of various doctors in the past five years was summarized as follows.

Clinical nursing visual health education pathway for patients with perianal abscess

Objective:To investigate the effect of a clinical nursing pathway and visual health education on patients with perianal abscesses was the objective of this study.Methods:Eighty patients with perianal abscesses undergoing in-patient surgical treatment(blinded for review)between December 2019 and November 2020 were divided randomly and evenly into a control group and an experimental group.The control group received routine nursing care,and the experimental group received visual health education nursing care.Digital pain scores,patient satisfaction scores,nursing quality scores,and scores measuring knowledge of perianal abscess disease for the two groups before and after nursing care were compared and analyzed.Results:The experimental group had visual analog scale(VAS)scores significantly lower than those of the control group(P<0.05).For total nursing satisfaction,the experimental group demonstrated a higher satisfaction rate(P<0.05).Clinical nursing quality scores were significantly higher in the experimental group than those in the control group(P<0.05).The perianal abscess disease-related knowledge scores after intervention were significantly higher in the experimental group than those in the control group(P<0.01).Conclusions:Visual health education nursing can help patients better understand and deal with perianal abscess disease.

Effect of calcium alginate dressing on the cytokine contents,collagen synthesis-degradation balance and apoptosis gene expression in the wound after perianal abscess surgery

Objective: To study the effect of calcium alginate dressing on the cytokine contents, collagen synthesis - degradation balance and apoptosis gene expression in the wound after perianal abscess surgery. Methods: Patients with perianal abscess who received surgical resection in the Eighth Hospital of Wuhan between May 2014 and February 2017 were selected and randomly divided into the group A who received calcium alginate dressing combined with kangfuxin solution and recombinant human epidermal growth factor for dressing change and the group B who received kangfuxin solution and recombinant human epidermal growth factor for dressing change. 3 d, 6 d and 9 d after dressing change, appropriate amount of wound tissue was collected to determine the expression of cytokines, collagen metabolites and apoptosis genes. Results: 3 d, 6 d and 9 d after dressing change, TGF-β1, Smad3, EGF and bFGF protein expression as well as Col-I, Col-II, Col-III, TIMP1 and TIMP2 protein expression in wounds of both groups of patients were increasing while Fas, FasL, Bax and Caspase-3 protein expression were decreasing, and TGF-β1, Smad3, EGF and bFGF protein expression as well as Col-I, Col-II, Col-III, TIMP1 and TIMP2 protein expression in wounds of group A were significantly higher than those of group B while Fas, FasL, Bax and Caspase-3 protein expression were significantly lower than those of group B. Conclusion: Calcium alginate dressing for wound dressing after perianal abscess surgery an increase the pro-proliferation cytokine expression, adjust the collagen synthesis - degradation balance and inhibit apoptosis, and it is conducive to wound healing.

Meta-Analysis of the Bacterial Detection Rate in Perianal Abscess

Literatures on the distribution of bacteria in perianal abscess from different regions and at different times were systematically analyzed,and the distribution of pathogens in perianal abscess was meta-analyzed using STATA 12.0 statistical software.The results showed that the detection rate of Escherichia coli was 0.64(95%CI,0.54-0.74),Klebsiella pneumoniae was 0.13(95%CI,0.12-0.15),and Staphylococcus was 0.07(95%CI,0.04-0.10).

Does capsule endoscopy have an added value in patients with perianal disease and a negative work up for Crohn's disease?

AIM:To investigate the role of capsule endoscopy in patients with persistent perianal disease and negative conventional work up for Crohn's disease(CD).METHODS:Patients with perianal disease(abscesses,fistulas,recurrent fissures) were evaluated for underlying CD.Patients who had a negative work up,defined as a negative colonoscopy with a normal ileoscopy or a normal small bowel series or a normal CT/MR enterography,underwent a Pillcam study of the small bowel after signing informed consent.Patients using nonsteroidal anti-inflammatory drugs or who had a history of inflammatory bowel disease or rheumatic disease were excluded.RESULTS:We recruited 26 patients aged 21-61 years(average 35.6 years),17 males and 9 females.One case could not be evaluated since the capsule did not leave the stomach.In 6 of 25(24%) patients with a negative standard work up for Crohn's disease,capsuleendoscopy(CE) findings were consistent with Crohn's disease of the small bowel.Family history of CD,white blood cell,hemoglobin,erythrocyte sedimentation rate or C-reactive protein did not predict a diagnosis of CD.Capsule endoscopy findings led to a change in treatment.CONCLUSION:In patients with perianal disease and a negative conventional work up to exclude CD,CE leads to incremental diagnostic yield of 24%.

Multidisciplinary and evidence-based management of fistulizing perianal Crohn's disease

Perianal symptoms are common in patients with Crohn's disease and cause considerable morbidity. The etiology of these symptoms include skin tags, ulcers, fissures, abscesses, fistulas or stenoses. Fistula is the most common perianal manifestation. Multiple treatment options exist although very few are evidence-based. The phases of treatment include: drainage of infection, assessment of Crohn's disease status and fistula tracts, medical therapy, and selective operative management. The impact of biological therapy on perianal Crohn's disease is uncertain given that outcomes are conflicting. Operative treatment to eradicate the fistula tract can be attempted once infection has resolved and Crohn's disease activity is controlled. The operative approach should be tailored according to the anatomy of the fistula tract. Definitive treatment is challenging with medical and operative treatment rarely leading to true healing with frequent complications and recurrence. Treatment success must be weighed against the risk of complications, specially anal sphincter injury. A full understanding of the etiology and all potential therapeutic options is critical for success. Multidisciplinary management of fistulizing perianal Crohn's disease is crucial toimprove outcomes.

Perianorectal abscesses and fistula due to ingested jujube pit in infant:Two case reports

BACKGROUND About 90%of perianal infection is caused by cryptoglandular infection.Only a few cases of peritonitis or intra-abdominal abscesses secondary to perforation of the digestive tract by an ingested foreign body have been reported.The most common sites of impaction and perforation include the appendix,cecum and the terminal ileum.The rectum is an unusual site of foreign body impaction.This report intends to highlight that ingested foreign body impacted in the rectum is an extremely rare cause of perianal abscess and subsequent fistula in infants.CASE SUMMARY Two cases of perianal abscess and fistula due to ingested jujube pit impacted in the rectum are reported.Both cases are infants with free previous medical history suffered from recurrent perianal infection.The caregivers of the two patients denied ingestion of a foreign body or any history of trauma.Physical examination combined with ultrasound or computed tomography scan established the diagnosis.Both of the patients underwent operation under general anesthesia.In case 1,a jujube pit with sharp ends was discovered embedded within a subcutaneous fistula.The jujube pit was then removed intact along with fistula resection.The wound was successfully laid open to allow healing by secondary intention.In case 2,a jujube pit was found with its sharp end puncturing the rectum,surrounded by pus and necrotic tissue.Subsequent incision and adequate drainage were performed.The whole jujube pit was then removed from the abscess cavity at the same time.Both patients received colonoscopy to rule out inflammatory bowel disease or other potential damages by the ingested jujube pit.The postoperative period was uneventful.At 1.5 year follow-up,no recurrent abscess or fistula were found in either patient.CONCLUSION An impacted foreign body must not be overlooked as an unusual cause of perianal abscess and fistula,especially in young children.

Malignant transformation of perianal tailgut cyst:A case report

BACKGROUND Tailgut cyst is a congenital enterogenous cyst that rarely undergoes malignant transformation.Its clinical manifestations mainly correlate to the mass effect caused by the development of cysts and the infections that originate from these.Furthermore,the complete resection of this cyst is curative.We report our diagnostic and treatment experience with one case of malignant transformation of a perianal tailgut cyst,which was initially misdiagnosed as perianal abscess.CASE SUMMARY A 72-year-old woman visited our institution with complaints of a refractory nonhealing lesion on the right hip,which repeatedly broke and suppurated for more than 70 years,and aggravated in 4 mo.The patient was given a diagnosis of refractory perianal abscess with repeated incision and drainage procedures.Computed tomography of the pelvic cavity revealed a giant perianal cyst.Subsequent biopsy revealed a tumor with moderate-to-severe glandular epithelial dysplasia,and suggested that this was derived from the developmental cysts in the posterior rectal space.After further clarifying the nature and extent of the tumor by magnetic resonance imaging,total cystic resection was performed.Postoperative histopathological examination confirmed the malignancy,dictating the investigators to add postoperative chemotherapy to the treatment regimen.CONCLUSION The malignant transformation of perianal tailgut cysts is very uncommon,and this should be differentiated from perianal abscess.Complete surgical removal is curative,and postoperative pathology may determine the necessity of additional postoperative chemotherapy or radiotherapy,which may be beneficial for preventing local recurrence and metastasis.

自拟中药外洗方对肛周脓肿术后患者创面愈合进程的影响研究

目的:探讨自拟中药外洗方对肛周脓肿术后患者创面愈合进程的影响。方法:选取2019年3月至2023年3月该院肛周脓肿术后患者100例,依据简单随机数字表法分为观察组与对照组,各50例。对照组患者采用高锰酸钾坐浴治疗,观察组患者采取自拟中药外洗方,均治疗2周。统计两组患者干预前后中医证候积分、临床疗效、创面康复情况(肛门疼痛程度、创面出血情况和创面愈合情况)、创面愈合时间(腐肉脱落时间、创面上皮出现时间和创面愈合时间)、炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和白细胞介素8(IL-8)]水平、转化生长因子-β1(TGF-β1)及血管内皮生长因子(VEGF)水平。结果:干预后,两组患者肛周肿痛、口干便秘、恶寒发热、夜寐不安和小便困难评分较干预前降低,且观察组患者较对照组降低,差异均有统计学意义(P<0.05)。观察组患者治疗总有效率(47/50,94.00%)高于对照组(40/50,80.00%),差异有统计学意义(P<0.05)。干预后,两组患者肛门疼痛程度、创面出血情况和创面愈合情况评分较干预前降低,且观察组患者较对照组降低,差异均有统计学意义(P<0.05)。观察组患者腐肉脱落时间、创面上皮出现时间和创面愈合时间短于对照组,差异均有统计学意义(P<0.05)。干预后,两组患者血清IL-6、TNF-α和IL-8水平较干预前降低,且观察组患者较对照组降低;干预后,两组患者血清TGF-β1、VEGF水平较干预前升高,且观察组患者较对照组升高,上述差异均有统计学意义(P<0.05)。结论:采取自拟中药外洗方干预肛周脓肿术后患者,可有效缓解临床症状,改善创面愈合情况,下调炎症因子水平,上调TGF-β1、VEGF水平,利于提高疾病整体干预效果。

肛痈促愈汤联合紫草纱条创面引流对肛周脓肿患者术后创面愈合的影响

目的观察肛痈促愈汤联合紫草纱条创面引流应用于肛周脓肿患者术后创面愈合的效果。方法选取2021年9月至2023年9月成都大学附属医院肛肠科收治的肛周脓肿患者100例,随机数字表法分为对照组与试验组,每组各50例。对照组患者于肛周脓肿根治术后实施常规处理,试验组则在常规处理基础上加用肛痈促愈汤口服结合紫草纱条创面引流,治疗时间为3周。比较2组治疗后创面愈合情况、疼痛程度、创面肉芽生长情况、血清炎症因子[血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、白细胞计数(WBC)]、血管内皮生长因子(VEGF)及表皮生长因子(EGF)。结果试验组腐肉完全脱落时间、创面愈合时间均短于对照组,治疗7 d后创面愈合率高于对照组,差异均有统计学意义(P均<0.05)。治疗7 d后2组的疼痛视觉模拟法评分(VAS)、创面肉芽生长情况评分均明显低于治疗1 d后,且试验组治疗7 d后疼痛VAS评分、创面肉芽生长情况评分显著低于对照组同期,差异均有统计学意义(P<0.05)。治疗3周后2组的SAA、CRP、WBC水平均显著低于治疗1 d后,VEGF、EGF水平均显著高于治疗1 d后,且试验组治疗3周后SAA、CRP、WBC水平显著低于对照组同期,VEGF、EGF水平显著高于对照组同期,差异均有统计学意义(P<0.05)。结论肛痈促愈汤结合紫草纱条创面引流应用于肛周脓肿患者术后创面愈合效果较好,可缓解创面疼痛,加快创面愈合,减轻炎症反应,促进组织再生修复。

白竭散对肛周脓肿术后创面愈合的疗效观察

目的观察白竭散对肛周脓肿术后创面愈合的作用。方法将60例患者随机分为治疗组和对照组,每组30例。两组均采用痔瘘洗剂坐浴和复方黄柏液涂剂清洗创面,治疗组在此基础上采用白竭散外敷创面。比较两组临床症状(肛门疼痛、水肿程度、创面分泌物)评分、肉芽生长情况评分、创面愈合率、创面组织细胞(毛细血管数、成纤维细胞数、巨噬细胞比)及疗效。结果术后3 d,两组创面指标(肛门疼痛、水肿程度、创面分泌物)评分及创面组织细胞(毛细血管数、成纤维细胞数、巨噬细胞比)比较,差异均无统计学意义(P>0.05)。术后7、14 d,治疗组创面指标(肛门疼痛、水肿程度、创面分泌物)评分、创面组织细胞(毛细血管数、成纤维细胞数、巨噬细胞比)均显著大于对照组(P<0.05)。治疗组疗效优于对照组(P<0.05)。结论白竭散促进肛周脓肿术后创面愈合效果显著,可缓解患者术后临床症状,促进术后肛门功能的恢复。

基于“去腐生肌”法探讨升白灵药纱条促进肛周脓肿术后创面愈合的动物实验研究

目的 观察升白灵药对肛周脓肿术后创面愈合的影响。方法 将40只SD大鼠分为空白组、模型组、雷夫诺尔组和升白灵药组,除空白组外其他三组用粪菌液造肛周脓肿模型,给药至大鼠创面完全愈合。观察大鼠创面愈合时间,第5天、10天、15天的闭合指数,创面第3天和第15天的白细胞水平,创面VEGF、b-FGF表达水平和炎症因子TNF-α、IL-6的表达水平。结果 升白灵药组和雷夫诺尔组大鼠创面完全愈合时间与模型组相比显著缩短(P<0.01),且升白灵组大鼠创面愈合时间短于雷夫诺尔组(P<0.01);升白灵药组和雷夫诺尔组大鼠创面第5天、10天、15天的闭合指数大于模型组(P<0.01),升白灵药组大鼠创面第5天、10天、15天的闭合指数均大于雷夫诺尔组(P<0.01);与空白组相比,3个造模组第3天白细胞计数均上升(P<0.01),与其余两组相比,升白灵药组白细胞上升更加显著(P<0.01);第15天雷夫诺尔组和升白灵药组大鼠白细胞计数低于模型组(P<0.01),与雷夫诺尔组相比,升白灵药组白细胞下降更加明显(P<0.01);升白灵药组大鼠背部创面组织VEGF的表达水平高于模型组和雷夫诺尔组(P<0.01);升白灵药组、雷夫诺尔组大鼠背部创面组织b-FGF的表达水平较模型组升高(P<0.01);升白灵药组b-FGF的表达水平较雷夫诺尔组升高(P<0.01);升白灵药组、雷夫诺尔组促炎因子IL-6、TNF-α的表达水平较模型组明显降低(P<0.01);升白灵药组大鼠背部创面组织促炎因子IL-6、TNF-α的表达水平较之雷夫诺尔组降低(P<0.01)。结论 以“去腐生肌”为遣方原则的升白灵药纱条能够通过调节炎症因子水平,上调VEGF、b-FGF表达促进肛周脓肿创面愈合。

散结透脓方外敷联合消肿清热解毒汤内服治疗泛发性肛周脓肿术后的效果及对创面愈合时间、肛门功能的影响

目的观察散结透脓方外敷联合消肿清热解毒汤内服在泛发性肛周脓肿术后的应用效果及对创面愈合时间、肛门功能的影响。方法将102例热毒炽盛型泛发性肛周脓肿术后患者按照随机数字表法分为2组,对照组51例术后予以抗感染及对症支持等治疗方法,治疗组51例在对照组基础上予以散结透脓方外敷联合消肿清热解毒汤内服治疗,2组均治疗4周。比较2组治疗后创面愈合情况(创面腐肉脱落时间、创面愈合时间、治疗2周创面回缩率)、治疗前后中医证候评分、治疗前和治疗2周疼痛视觉模拟评分(VAS)、治疗前和术后2个月肛门失禁Wexner评分量表评分、治疗前和治疗2周炎症相关指标[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素6(IL-6)],并统计2组临床疗效,记录治疗期间不良反应发生情况。结果治疗组总有效率90.20%(46/51),对照组总有效率74.51%(38/51),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组创面腐肉脱落时间、愈合时间均低于对照组(P<0.05),治疗2周时创面回缩率高于对照组(P<0.05)。2组治疗2周时疼痛VAS均较本组治疗前降低(P<0.05),且治疗组治疗2周时疼痛VAS低于对照组同期(P<0.05)。2组术后2个月Wexner评分均较本组治疗前降低(P<0.05),且治疗组术后2个月Wexner评分低于对照组同期(P<0.05)。2组治疗2周后外周血WBC、CRP、IL-6水平均较本组治疗前降低(P<0.05),且治疗组治疗2周后均低于对照组同期(P<0.05)。结论散结透脓方外敷联合消肿清热解毒汤内服可提高泛发性肛周脓肿术后疗效,缩短愈合时间,减轻术后疼痛,缓解炎症反应,有利于改善患者肛门功能。

葫芦灸对肛周脓肿术后提高临床愈合效果的探讨

目的 探究葫芦灸对肛周脓肿术后提高临床愈合效果的作用。方法 方便选取2021年1月—2022年12月临沂市中医医院收治的94例肛周脓肿患者为研究对象,均经手术治疗,依据随机数表法分为对照组与观察组,每组47例。对照组采用常规术后治疗方法,观察组在对照组基础上使用葫芦灸治疗方法。对比两组干预后的总有效率、疼痛评分、生活质量、临床指标、并发症发生率。结果 观察组干预后总有效率和生活质量评分高于对照组,差异有统计学意义(P均<0.05)。观察组愈合时间短于对照组及治疗24 h后渗液量少于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率(2.13%)低于对照组(17.02%),差异有统计学意义(χ^(2)=4.424,P<0.05)。结论 肛周脓肿患者术后给予葫芦灸治疗,可显著提高愈合效果,缩短治疗时间,有效改善患者生活质量,效果显著。

疮愈膏外敷促进湿热蕴结证肛周脓肿术后创面愈合临床研究

目的:观察疮愈膏外敷对湿热蕴结证肛周脓肿术后创面愈合的促进作用。方法:将70例湿热蕴结证肛周脓肿患者按随机数字表法分为治疗组和对照组,每组35例。在术后常规换药基础上,治疗组给予疮愈膏外敷创面治疗,对照组则给予凡士林纱条外敷创面治疗。比较2组临床疗效、创面愈合时间、疼痛评分、创面分泌物评分、肛门功能指标及血清炎症指标水平。结果:治疗2周后,治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗组创面愈合时间短于对照组,差异有统计学意义(P<0.05)。治疗2周后,2组疼痛、创面分泌物评分均较术后第2天降低,治疗组疼痛、创面分泌物评分均低于对照组,差异均有统计学意义(P<0.05)。治疗2周后,2组肛管静息压、肛管最大收缩压均较术前降低,治疗组肛管静息压、肛管最大收缩压均低于对照组,差异均有统计学意义(P<0.05)。治疗2周后,2组血清C-反应蛋白(CRP)、白细胞介素-6 (IL-6)及肿瘤坏死因子-α (TNF-α)水平均较术后第2天降低,治疗组血清CRP、IL-6及TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。结论:疮愈膏外敷可有效改善肛周脓肿湿热蕴结证术后患者的临床症状,降低炎症指标水平,改善肛门功能,促进创面愈合。