【摘要】 目的 观察采用4 MHz射频消融系统治疗肛瘘的临床疗效。方法 选取2023年10月1日至2023年12月31日南京市中医院肛肠科收治的60例括约肌间型或经括约肌型肛瘘患者，按照随机数字表法分为观察组（采用4 MHz射频消融系统治疗）和对照组（采用肛瘘切开术治疗），每组各30例。比较两组的治愈率、复发率、创面疼痛程度（采用视觉模拟评分评估）、创面愈合时间、术后并发症（出血、切口感染、锁眼样畸形、肛缘水肿、尿潴留和肛门坠胀）以及肛门功能（采用Wexner肛门失禁评分评估）情况。结果 术后3个月，观察组治愈率为86.7%，对照组治愈率为93.3%，比较差异无统计学意义（校正χ~2=0.185,P=0.667）。术后6个月，观察组复发率为10%，对照组复发率为3.3%，比较差异无统计学意义（χ~2=0.268,P=0.605）。观察组术后第1、第7天创面疼痛视觉模拟评分低于对照组（P<0.05）。观察组创面愈合时间为（30.6±3.5） d，对照组创面愈合时间为（38.2±4.7） d，比较差异有统计学意义（P<0.05）。观察组并发症总发生率低于对照组（P<0.05）。两组术前Wexner肛门失禁评分比较差异无统计学意义（P>0.05）；术后3个月，观察组Wexner肛门失禁评分低于对照组（P<0.05）。结论 与肛瘘切开术相比，基于4 MHz射频消融系统治疗肛瘘的临床疗效相当，在减轻创面疼痛，加速创面愈合，减少肛门坠胀、尿潴留等并发症，保护肛门功能方面具有优势。更多还原

【Abstract】 Objectives To observe the clinical efficacy of 4 MHz radiofrequency ablation system in the treatment of anal fistula.Methods Sixty patients with intersphincteric or transsphincteric anal fistula who were admitted to the Anorectal Department of Nanjing Hospital of Traditional Chinese Medicine from October 1,2023 to December 31,2023 were selected and divided into the observation group(treated with 4 MHz radiofrequency ablation system) and the control group(treated with anal fistulectomy) according to random number table method,with 30 cases in each group.The cure rate,recurrence rate,wound pain intensity(assessed using the Visual Analog Scale,VAS),wound healing time,postoperative complications(including bleeding,incision infection,keyhole deformity,anal edema,urinary retention,and anal distension),and anal function(assessed using the Wexner anal incontinence score) were compared between the two groups.Results At 3 months after surgery,the cure rate was 86.7% in the observation group and 93.3% in the control group,with no significant difference(adjusted χ~2=0.185,P=0.667).At 6 months after surgery,the recurrence rate was 10% in the observation group and 3.3% in the control group,with no significant difference(χ~2=0.268,P=0.605).The observation group had lower VAS scores for wound pain on the 1st and 7th days after surgery compared to the control group(P <0.05).The wound healing time was(30.6±3.5) days in the observation group and(38.2±4.7) days in the control group,with a statistically significant difference(P <0.05).The total incidence of complications in the observation group was lower than that in the control group P <0.05).There was no statistically significant difference in Wexner anal incontinence score between the two groups before surgery(P> 0.05).At 3 months after surgery,the Wexner anal incontinence score of the observation group was lower than that of the control group,(P <0.05).Conclusion Compared with anal fistulotomy,the clinical efficacy of the 4 MHz radiofrequency ablation system in treating anal fistula is comparable.It offers advantages in reducing wound pain,accelerating wound healing,decreasing complications such as anal tenesmus and urinary retention,and protecting anal function.更多还原