不同手術(shù)方式治療高位復(fù)雜肛瘺的臨床效果分析

那云朗　富羽翔　蘇震宇　范陸洋

[摘要] 目的 研究高位復(fù)雜肛瘺使用不同手術(shù)治療的臨床效果。 方法 臨床納入80例該院2012年8月—2014年8月期間收治的高位復(fù)雜肛瘺患者，將所有患者按照隨機(jī)抽樣法分為兩組各40例。其中40例患者使用外切內(nèi)掛膠管引流術(shù)進(jìn)行治療作為觀察組，另40例患者使用切開掛線術(shù)進(jìn)行治療作為對(duì)照組。結(jié)果 觀察組治療總有效率高達(dá)100%，復(fù)發(fā)率僅為2.5%，遠(yuǎn)好于對(duì)照組的95%、15%，P<0.05；而術(shù)后住院時(shí)間、傷口愈合時(shí)間及住院費(fèi)用，觀察組均優(yōu)于對(duì)照組，P<0.05。結(jié)論外切內(nèi)掛膠管引流術(shù)治療高位復(fù)雜肛瘺效果顯著，預(yù)后良好，術(shù)后復(fù)發(fā)率低，且費(fèi)用較低，值得臨床應(yīng)用及推廣。

[關(guān)鍵詞] 高位復(fù)雜肛瘺；不同手術(shù)；臨床效果

[中圖分類號(hào)] R657.16 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2015）04（c）-0035-02

[Abstract] Objective To study the clinical effects of different surgical options for high complex anal fistula. Methods 80 patients with higher complex anal fistula treated from August 2012 to August 2014 in our hospital were selected and randomly divided into two groups， 40 cases each group. The observation group received the circumscribed drainage combined with hose drainage inside while control group received the incision-thread-drawing procedure. Results The total effective rate and recurrence rate of observation group were 100% and 2.5% while the respective rates of control group were 95% and 15% （P<0.05）. LOS after surgery， time of wound healing and hospitalization costs of observation group were better than those of control group（P<0.05）. Conclusion The circumscribed drainage combined with hose drainage inside has an obvious treatment effect for high complex anal fistula with favorable prognosis and lower recurrence rate and costs， which is worthy of clinical application and promotion.

[Key words] High complex anal fistula； Different surgeries； Clinical effect

肛瘺是肛腸科最常見的疾病之一，發(fā)生率高，多數(shù)屬于隱窩腺源性肛瘺。其是由內(nèi)口、瘺管、外口三部分構(gòu)成，治療較為復(fù)雜，傷口難以愈合，復(fù)發(fā)率較高[1]。而高位復(fù)雜肛瘺是指病變部位較高，有兩個(gè)以上外口與內(nèi)口、瘺管相連，并可能伴有支管及空腔的肛瘺，治療更加困難，是醫(yī)學(xué)界的一個(gè)難題[2-3]。近些年來對(duì)肛瘺的治療方法較多，該研究隨機(jī)選取2012年8月—2014年8月間該院收治的80例高位復(fù)雜肛瘺患者為研究對(duì)象，研究外切內(nèi)掛膠管引流術(shù)與切開掛線術(shù)對(duì)高位復(fù)雜肛瘺治療的臨床效果，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

該研究隨機(jī)選取的80例研究對(duì)象均為該院收治的高位復(fù)雜肛瘺患者，所有患者經(jīng)檢查和診斷符合高位復(fù)雜肛瘺診斷標(biāo)準(zhǔn)[4]。患者均自愿參加該次研究并簽字同意。納入標(biāo)準(zhǔn)：①肛瘺管數(shù)在兩個(gè)以上；②兩個(gè)以上管道與內(nèi)相連；③內(nèi)口明確，非特異性感染患者等。按隨機(jī)抽樣法將患者分為兩組各40例。……