經括約肌間肛瘺結扎術治療高位肛瘺的臨床研究

王菁++石榮++黃娟

[摘要]目的 研究經括約肌間肛瘺結扎術治療高位肛瘺的臨床效果。方法 選取我院2013年10月～2015年5月的60例高位經括約肌肛瘺患者，按照隨機數字表法分成治療組和對照組，各30例。治療組采用經括約肌間肛瘺結扎術，對照組采用傳統切開掛線術。觀察兩組的住院時間、創面愈合時間，分別于術前1 d及術后第3個月評價患者的肛門功能情況。結果 兩組均順利完成手術，兩組的手術時間、治愈率、復發率、隨訪時間、大便失禁例數比較，差異無統計學意義（P>0.05）。治療組的重返日常活動時間、住院天數和創面愈合時間短于對照組，差異有統計學意義（P<0.05）。兩組術后3個月的Wexner分值、肛管最大收縮壓、肛管靜息壓、直腸最小感覺容量、初始排便容量、最大耐受容量、最大收縮波幅優于治療前，治療組術后3個月的Wexner分值、肛管最大收縮壓、肛管靜息壓、直腸最小感覺容量、初始排便容量、最大耐受容量、最大收縮波幅優于對照組，差異有統計學意義（P<0.05）。結論 與傳統切開掛線術相比，經括約肌間肛瘺結扎術的住院天數短，愈合時間短，能更快地重返日?；顒?，可以在保證治愈率前提下又能更好地保護肛門括約肌功能，具有重要的臨床意義。

[關鍵詞]經括約肌間肛瘺結扎術；高位肛瘺；肛門功能；臨床研究

[中圖分類號] R657.1+6 [文獻標識碼] A [文章編號] 1674-4721（2017）08（b）-0014-04

Clinical study of ligation of intersphincteric fistula tract in the treatment of high anal fistula

WANG Jing SHI Rong▲ HUANG Juan

Department of Anorectal Surgery，People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine，Fujian Province，Fuzhou 350004，China

[Abstract]Objective To study the clinical efficacy of ligation of intersphincteric fistula tract in the treatment of high anal fistula.Methods From October 2013 to May 2015，60 patients with high sphincter anal fistula in our hospital were selected and divided into the treatment group （n=30） and the control group （n=30） according to random number table method.The treatment group was treated with ligation of intersphincteric fistula tract，and the control group was given the traditional incision and thread technique.The time of hospitalization and wound healing were observed in the two groups.The anus function was evaluated at 1 day before operation and 3 months after operation.Results The two groups completed the operation successfully，there were no significant differences in the operation time，cure rate，recurrence rate，follow-up time and the number of fecal incontinence between the two groups （P>0.05）.The time to return to routine activities，hospitalization and wound healing time in the treatment group was shorter than that in the control group，with significant difference （P<0.05）.The Wexner score，maximum systolic pressure of anal canal，anal canal rest pressure，rectal minimum sensory capacity，initial defecation capacity，maximum tolerance capacity and maximum systolic amplitude in the two groups at 3 months after treatment was better than that before treatment，the Wexner score，maximum systolic pressure of anal canal，anal canal rest pressure，rectal minimum sensory capacity，initial defecation capacity，maximum tolerance capacity and maximum systolic amplitude in the treatment group at 3 months after treatment was better than that in the control group，with significant difference （P<0.05）.Conclusion Compared with the traditional incision and thread technique，ligation of intersphincteric fistula tract can shorten hospitalization and healing time，which can return to daily activities faster，can ensure the cure rate and better protect the anal sphincter function，so it has important clinical significance.endprint