| 摘要: |
| 目的：观察全程可控性定向挂线术治疗高位肛瘘的临床疗效。方法：将60例高位肛瘘患者随机分为治疗组和对照组，每组各30例。治疗组采用全程可控性定向挂线术治疗，对照组采用常规切开挂线术治疗。观察2组综合疗效、疼痛评分、Wexner便秘评分、肛管静息压（ARP）、肛管最大收缩压（AMCP）、创面愈合时间及脱线时间。结果：总有效率治疗组为93.33%（28/30），对照组为100%（30/30），2组比较，差异无统计学意义（P>0.05）。术后第8～14天及第15～21天治疗组视觉模拟评分量表（VAS）评分明显低于对照组，差异均有统计学意义（P＜0.05）。2组术前及术后1个月Wexner便秘评分比较，差异无统计学意义（P＜0.05）；但术后3个月治疗组Wexner便秘评分明显低于对照组，差异有统计学意义（P＜0.05）。2组术后ARP及AMCP较术前均有所下降，但治疗组较对照组下降幅度小，差异均有统计学意义（P＜0.05）。2组创面愈合时间及脱线时间比较，差异均无统计学意义（P>0.05）。结论：全程可控性定向挂线术与传统切开挂线相比，在维护肛门形态、减轻术后疼痛和保护肛门括约肌功能方面有明显优势。 |
| 关键词: 高位肛瘘 全程可控性定向挂线术 切开挂线术 |
| DOI： |
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| Clinical effect of controllable thread-drawing surgery in treatment of high anal fistula |
| ZHOU Fangping,QIU Yunzhong,ZHANG Jingyan |
| (Changzhou Wujin Hospital of Traditional Chinese Medicine，Changzhou 213000，Jiangsu，China) |
| Abstract: |
| Objective：To investigate the clinical effect of controllable thread-drawing surgery in the treatment of high anal fistula.Methods：A total of 60 patients with higher anal fistula were randomly divided into treatment group and control group，with 30 patients in each group.The patients in the treatment group were given controllable thread-drawing surgery，and those in the control group were given conventional incision and thread-drawing.The two groups were compared in terms of overall response，pain score，Wexner constipation score，anal resting pressure (ARP)，anal maximum contraction pressure (AMCP)，wound healing time，and thread removal time.Results：There was no significant difference in overall response rate between the treatment group and the control group［93.33% (28/30) vs 100% (30/30)，P>0.05］.On days 8～14 and 15～21 after surgery，the treatment group had a significantly lower Visual Analogue Scale score than the control group (P<0.05).There was no significant difference in Wexner constipation score between the two groups before surgery and at 1 month after surgery (P<0.05)，but at 3 months after surgery，the treatment group had a significantly lower Wexner constipation score than the control group (P<0.05).Both groups had significant reductions in ARP and AMCP after treatment，and the treatment group had significantly less reductions than the control group (P<0.05).There were no significant differences between the two groups in wound healing time and thread removal time (P>0.05).Conclusion：Compared with conventional incision and thread-drawing，controllable thread-drawing surgery has obvious advantages in maintaining anal morphology，reducing postoperative pain，and protecting the function of the anal sphincter. |
| Key words: high anal fistula controllable thread-drawing surgery incision and thread-drawing |
