CAJ | 학술논문

目的：探讨肛腺切除并桥式引流术治疗复杂性肛瘘的临床疗效。方法将120例复杂性肛瘘患者随机分为2组，各60例。治疗组采用肛腺切除并桥式引流术治疗，对照组采用常规切开挂线术治疗。观察比较2组疗效及并发症情况、伤口痊愈时间、术后创面原始面积、创面痊愈后瘢痕面积、肛门功能（漏气漏液、肛门失禁Wexner评分）、肛管静息压及最大收缩压的变化情况。结果2组患者均全部痊愈出院，治疗组并发症发生率低于对照组（P＜0．05），伤口痊愈时间短于对照组（P＜0．05），术后创面原始面积及创面愈合后瘢痕面积均小于对照组（P＜0．05），治疗组治疗前后肛管静息压及最大收缩压均无明显变化（P＞0．05），而对照组治疗后均有所下降（P＜0．05）。结论采用肛腺切除并桥式引流术治疗复杂性肛瘘临床疗效确切，可以明显缩短痊愈时间，减少术后创面原始面积及创面痊愈后瘢痕面积，预防肛门漏气漏液，维持肛管静息压及最大收缩压。
목적：탐토항선절제병교식인류술치료복잡성항루적림상료효。방법장120례복잡성항루환자수궤분위2조，각60례。치료조채용항선절제병교식인류술치료，대조조채용상규절개괘선술치료。관찰비교2조료효급병발증정황、상구전유시간、술후창면원시면적、창면전유후반흔면적、항문공능（루기루액、항문실금Wexner평분）、항관정식압급최대수축압적변화정황。결과2조환자균전부전유출원，치료조병발증발생솔저우대조조（P＜0．05），상구전유시간단우대조조（P＜0．05），술후창면원시면적급창면유합후반흔면적균소우대조조（P＜0．05），치료조치료전후항관정식압급최대수축압균무명현변화（P＞0．05），이대조조치료후균유소하강（P＜0．05）。결론채용항선절제병교식인류술치료복잡성항루림상료효학절，가이명현축단전유시간，감소술후창면원시면적급창면전유후반흔면적，예방항문루기루액，유지항관정식압급최대수축압。
Objective To explore the clinical effect of complex anal fistula treated by anal gland excision and bridge drainage .Methods 120 cases of complex anal fistula were randomly divided into two groups .60 cases in treatment group received anal gland excision and bridge drainage treatment .60 cases in control group were treated by conventional incision line treatment .Results The changes of the complication rate in treatment group was more than that of the control group (P<0.05),wound healing time was shorter than the control group (P<0.05),after the o-riginal area of the wound after wound healing and scar area were lower than the control group (P<0.05).Postopera-tive wound primitive area and scar area after the wounds healed in treatment group was less than that in control group (P<0.05).There was no difference between before and after treatment on anal resting pressure and maximum sys -tolic blood pressure in treatment group (P>0.05).Anal resting pressure and maximum systolic blood pressure was reduced (P<0.05).Conclusion Anal gland excision and bridge drainage has definite effect on the treatment of complex anal fistula ,it can obviously shorten recovery time ,reduce postoperative wound primitive area and scar area after the wounds healed ,prevent of anal leakage leakage ,maintain anal resting pressure and maximum systolic blood pressure.