皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2013年
6期
477-479,480
,共4页
肛周脓肿%挂线疗法%临床经验%引流
肛週膿腫%掛線療法%臨床經驗%引流
항주농종%괘선요법%림상경험%인류
perianal abscess%thread-drawing method%clinical experi-ence%drainage
目的：研究挂线引流法治疗高位肛管直肠周围脓肿的临床疗效及其对术后疼痛、肛管缺损和肛门功能评分的影响。方法：对高位肛管直肠周围脓肿采用挂线引流疗法和一次性切开挂线疗法进行治疗，分别观察两组的疗效、创面愈合时间、术后疼痛、肛管缺损、肛门功能评分。结果：试验组和对照组的近期治愈率均为100％，经半年以上随访，试验组远期治愈率为96．2％（25/26），对照组远期治愈率为100％（23/23），但两组间并无显著性差异（χ2＝0．004， P＞0．05）；试验组创面愈合时间为（24．20±1．97）d，对照组创面愈合时间为（26．20±2．30） d。试验组显著短于对照组（ t＝4．667， P ＜0．01）；术后试验组疼痛积分平均为1．94±0．71，对照组疼痛积分平均为2．72±0．81，试验组积分明显优于对照组（t＝5．118，P＜0．01）；术后试验组患者均未发现明显漏气漏液和肛管锁眼畸形，对照组有16例患者出现肛管锁眼畸形，两组间有显著性差异（χ2＝51．515， P＜0．01）；按照Wexner的肛门功能评分法对患者术后肛门功能进行了评价，试验组的肛门功能评分为0．56±0．50，对照组的肛门功能评分为1．34±0．63，以试验组的肛门功能为优（ t＝6．935，P＜0．01）。结论：挂线引流法治疗高位肛管直肠周围脓肿与一次性切开挂线术的临床治愈率、疗程相近，但在术后疼痛、术后肛管缺损、肛门功能评分方面较一次性切开挂线组为优。
目的：研究掛線引流法治療高位肛管直腸週圍膿腫的臨床療效及其對術後疼痛、肛管缺損和肛門功能評分的影響。方法：對高位肛管直腸週圍膿腫採用掛線引流療法和一次性切開掛線療法進行治療，分彆觀察兩組的療效、創麵愈閤時間、術後疼痛、肛管缺損、肛門功能評分。結果：試驗組和對照組的近期治愈率均為100％，經半年以上隨訪，試驗組遠期治愈率為96．2％（25/26），對照組遠期治愈率為100％（23/23），但兩組間併無顯著性差異（χ2＝0．004， P＞0．05）；試驗組創麵愈閤時間為（24．20±1．97）d，對照組創麵愈閤時間為（26．20±2．30） d。試驗組顯著短于對照組（ t＝4．667， P ＜0．01）；術後試驗組疼痛積分平均為1．94±0．71，對照組疼痛積分平均為2．72±0．81，試驗組積分明顯優于對照組（t＝5．118，P＜0．01）；術後試驗組患者均未髮現明顯漏氣漏液和肛管鎖眼畸形，對照組有16例患者齣現肛管鎖眼畸形，兩組間有顯著性差異（χ2＝51．515， P＜0．01）；按照Wexner的肛門功能評分法對患者術後肛門功能進行瞭評價，試驗組的肛門功能評分為0．56±0．50，對照組的肛門功能評分為1．34±0．63，以試驗組的肛門功能為優（ t＝6．935，P＜0．01）。結論：掛線引流法治療高位肛管直腸週圍膿腫與一次性切開掛線術的臨床治愈率、療程相近，但在術後疼痛、術後肛管缺損、肛門功能評分方麵較一次性切開掛線組為優。
목적：연구괘선인류법치료고위항관직장주위농종적림상료효급기대술후동통、항관결손화항문공능평분적영향。방법：대고위항관직장주위농종채용괘선인류요법화일차성절개괘선요법진행치료，분별관찰량조적료효、창면유합시간、술후동통、항관결손、항문공능평분。결과：시험조화대조조적근기치유솔균위100％，경반년이상수방，시험조원기치유솔위96．2％（25/26），대조조원기치유솔위100％（23/23），단량조간병무현저성차이（χ2＝0．004， P＞0．05）；시험조창면유합시간위（24．20±1．97）d，대조조창면유합시간위（26．20±2．30） d。시험조현저단우대조조（ t＝4．667， P ＜0．01）；술후시험조동통적분평균위1．94±0．71，대조조동통적분평균위2．72±0．81，시험조적분명현우우대조조（t＝5．118，P＜0．01）；술후시험조환자균미발현명현루기루액화항관쇄안기형，대조조유16례환자출현항관쇄안기형，량조간유현저성차이（χ2＝51．515， P＜0．01）；안조Wexner적항문공능평분법대환자술후항문공능진행료평개，시험조적항문공능평분위0．56±0．50，대조조적항문공능평분위1．34±0．63，이시험조적항문공능위우（ t＝6．935，P＜0．01）。결론：괘선인류법치료고위항관직장주위농종여일차성절개괘선술적림상치유솔、료정상근，단재술후동통、술후항관결손、항문공능평분방면교일차성절개괘선조위우。
Objective:To evaluate the clinical efficacy, postoperative pain,anal sphincter defects and scores of anal function in patients with superior anorectal abscess managed with thread drainage technique . Methods: One hundred patients with upper anorectal abscess were equal-ly allocated to two groups and treated with either thread drainage tech-nique or one step incision thread-drawing method.The two groups were observed regarding the curative effects,duration of wound healing,postop-erative pain,incidence of anal sphincter defects and scores of anal func-tion.Results: The short-term curative rates were 100% for both experi-mental and control groups.Follow-up over half a year time showed that the long-term curative rate was 96.2%(25/26) for the experimental group and 100%(23/23)for the controls,yet the two groups were not statistical-ly different(χ2 =0.004,P>0.05).The wound healing time was shorter and the average scores of postoperative pain was lower in the experimental group than the control group(24.20 ±1.97 d vs.26.20 ±2.30 d)(1.94 ±0.71 vs.2.72 ±0.81)(t=4.667,P<0.01; t=5.118,P<0.01,re-spectively) .No incidence of obvious leakage discharge and keyhole-like deformity occurred postoperatively in the experimental group ,yet such in-cidence was seen in the control group( n=16) .The two groups were sig-nificantly different(χ2 =51.515,P<0.01).By Wexner scale for postop-erative anal incontinence,the score was 0.56 ±0.50 for the experimental group and 1.34 ±0.63 for the controls ( t =6.935, P <0.01 ). Conclusion: The two approaches to upper anorectal abscess are compara-ble concerning the curative effects and course of treatment ,yet the postop-erative pain,incidence of anal sphincter defects and anal function scores seem superior in application of thread drainage to one step incision thread-drawing method.
