【摘要】 目的观察括约肌间入路加隧道式拖线引流术治疗马蹄形肛周脓肿的疗效。方法将78例马蹄型肛周脓肿患者随机分为治疗组、对照组,每组39例。对照组采用多切口引流术治疗,治疗组采用括约肌间入路加隧道式拖线引流术治疗。观察临床疗效,比较两组术后1 d、7 d、10 d、14 d创面渗液、肛门疼痛及发热情况;随访半年,观察比较两组复发率、成瘘率及肛瘘类型。结果①治疗组痊愈、显效、未愈病例数分别为21、17、1,对照组分别为12、19、8,治疗组临床疗效优于对照组(P<0.05)。②治疗组、对照组复发率分别为2.6%、20.5%,成瘘率分别为46.2%、69.2%,复杂性肛瘘占比分别为33.3%、70.4%,治疗组复发率、成瘘率、复杂性肛瘘占比低于对照组(P<0.05)。③术后10 d、14 d组间比较,治疗组创面渗液少于对照组(P<0.05);术后7 d、10 d、14 d组间比较,治疗组肛门疼痛轻于对照组(P<0.05);术后1 d组间比较,治疗组发热程度低于对照组(P<0.05)。结论括约肌间入路加隧道式拖线引流术治疗马蹄形肛周脓肿疗效满意,与传统多切口引流术相比,更利于术后恢复,并能有效降低术后复发率,减少术后肛瘘的形成,尤其是复杂性肛瘘的发生。更多还原

【Abstract】 Objective To observe the clinical efficacy of horseshoe-shaped perianal abscess treatment by the way of sphincter approach and tunnel thread-drawing therapy. Methods A total of 78 hospitalized patients of horseshoe-shaped perianal abscess were divided into treatment group and control group randomly,39 cases in each group. The treatment group used the way of inter sphincter approach and tunnel thread-drawing therapy while the control group used multi-incision drainage. The clinical effect was observed,and the wound exudation,bleeding,anal pain and fever of the two groups on the 1st,7th,10th and 14th day after operation were compared; and those patients were followed for half a year with the recurrence rate,fistula rate and anal fistula type of the two groups being observed and compared. Results ①The number of cured,effective and non-cured cases in the treatment group was 21,17 and 1 respectively,while that in the control group was 12,19 and 8 respectively. The clinical effect of the treatment group was better than that of the control group( P<0.05). ② The recurrence rate of the treatment group and the control group was 2.6% and 20.5% respectively,the fistula rate was 46.2% and 69.2% respectively,and the proportion of complex anal fistula was 33.3% and 70.4% respectively. The recurrence rate,fistula rate and complex anal fistula rate of the treatment group were lower than those of the control group( P<0.05). ③ On the 10th and 14th day after operation,cases with wound exudation in the treatment group were fewer than those in the control group( P<0.05); on the 7th,10th and 14th day after operation,cases with anal pain in the treatment group were fewer than those in the control group( P<0.05); on the 1st day after operation,the fever degree in the treatment group was lower than that in the control group( P<0.05). Conclusion Compared with the traditional multi-incision drainage,the treatment of horseshoe-shaped perianal abscess by the way of sphincter approach combined with tunnel thread-drawing therapy is more conducive to postoperative recovery, and can effectively reduce the recurrence rate and the formation of postoperative anal fistula,especially the occurrence of complex anal fistula.更多还原