广州医科大学学报

目的:探讨虚实结合挂线法对高位复杂性肛瘘患者术后创面愈合及肛门功能的影响。方法:选取2016年10月至2018年8月收治的75例高位复杂性肛瘘患者作为研究对象,根据治疗方法不同分为两组:对照组(30例)采用内口上方实挂线法治疗,观察组(45例)采用虚实结合挂线法治疗。比较两组治愈率、术后3个月复发率,瘢痕面积,创面愈合时间,术后大便失禁严重度评分表(Wexner),术后1、3、5、7 d视觉模拟评分(VAS)等指标。结果:观察组和对照组的治愈率、术后3个月复发率分别为97.78%、2.22%和100.00%、0,两组比较,差异无统计学意义(P>0.05);观察组瘢痕面积、创面愈合时间、Wexner评分低于对照组(P<0.05);观察组术后1、3、5、7 d VAS评分均低于对照组(P<0.05)。结论:虚实结合挂线法是治疗高位复杂性肛瘘的有效方法,能减轻术后疼痛,减少瘢痕面积,促进创面愈合,保护肛门功能,应用价值较高。

Objective: To investigate the effects of loose-and-tight thread-drawing therapy on wound healing and anal function in patients with high complex anal fistula. Methods: Seventy-five patients with high complex anal fistula admitted to our hospital between October 2016 and August 2018 were included in the study. According to different treatment methods,the patients were divided into two groups. The control group( n = 30) was treated with the traditional tight thread-ligating therapy. The study group( n = 45) was treated with loose-and-tight threaddrawing therapy. The cure rate,recurrence rate at 3 months after the operation,scar area,time to wound healing,postoperative fecal incontinence severity( Wexner) scores,and the visual analogue scale( VAS) scores at 1,3,5 and 7 d after the operation in the two groups was compared. Results: The cure rate and the recurrence rate at 3 months after the operation in the study group and control group were 97.78% vs. 100.00% and 2.22%vs. 0,respectively,with no statistically significant differences between the two groups( P>0.05). The scar area,time to wound healing,and Wexner scores in the study group were lower than those in the control group( P <0. 05). The VAS scores at 1,3,5 and 7 d after the operation in the study group were lower than those in the control group( P < 0. 05). Conclusion: Loose-and-tight thread-drawing therapy is an effective method for the treatment of high complex anal fistula. It may reduce postoperative pain,decrease scar area,promote wound healing,and protect anal function,with promising value for use in clinical setting.