CAJ | 학술논문

目的评价对口切开皮桥保留术治疗低位经括约肌肛瘘的临床效果与安全性.方法将60例低位经括约肌肛瘘患者随机分为治疗组和对照组,治疗组30例采用对口切开皮桥保留术,对照组30例采用肛瘘切除术,观察两组患者术后第2、7、14天的疼痛、渗液、发热情况,创面愈合时间,术后肛管狭窄及肛门失禁等后遗症情况,术前与术后3个月肛管直肠压力变化情况,以评价对口切开皮桥保留术的临床疗效与安全性.结果治疗组术后第2、7、14天的疼痛、渗液情况与对照组相比差异均有统计学意义(P均＜0.01);治疗组平均愈合时间为(27.37±8.93)d,少于对照组(32.73±9.45)d,差异有统计学意义(P=0.00);两组术后3个月随访肛管静息压、肛管最大收缩压、主动收缩压比较差异均有统计学意义(t值分别为13.12、10.21、12.10,P均＜0.01);两组均无肛管狭窄、肛门失禁发生;两组在总体疗效方面差异无统计学意义(100％与93.3％;x2=2.07,P＞0.05).结论对口切开皮桥保留术治疗低位经括约肌肛瘘能减少术后疼痛、渗液、发热,缩短创面愈合时间,较好保护肛门功能.
목적 평개대구절개피교보류술치료저위경괄약기항루적림상효과여안전성.방법 장60례저위경괄약기항루환자수궤분위치료조화대조조,치료조30례채용대구절개피교보류술,대조조30례채용항루절제술,관찰량조환자술후제2、7、14천적동통、삼액、발열정황,창면유합시간,술후항관협착급항문실금등후유증정황,술전여술후3개월항관직장압력변화정황,이평개대구절개피교보류술적림상료효여안전성.결과 치료조술후제2、7、14천적동통、삼액정황여대조조상비차이균유통계학의의(P균＜0.01);치료조평균유합시간위(27.37±8.93)d,소우대조조(32.73±9.45)d,차이유통계학의의(P=0.00);량조술후3개월수방항관정식압、항관최대수축압、주동수축압비교차이균유통계학의의(t치분별위13.12、10.21、12.10,P균＜0.01);량조균무항관협착、항문실금발생;량조재총체료효방면차이무통계학의의(100％여93.3％;x2=2.07,P＞0.05).결론 대구절개피교보류술치료저위경괄약기항루능감소술후동통、삼액、발열,축단창면유합시간,교호보호항문공능.
Objective To evaluate the curative effects and safty of contra-aperture dissection and skin bridge preservation in the treatment of low transphincteric perianal fistula.Methods Sixty subjects of low transphincteric perianal fistula were randomly divided into two groups.Thirty cases of treatment group were treated by contra-aperture dissection and skin bridge preservation,and 30 cases of control group were treated by anal fistulectomy.On the second,seventh and fourteenth day after operation,the postoperative pain,exudate and fever were recorded and scored.The curative time was observed.Anorectal dynamic changes were compared simultaneously to evaluate the curative effects and safety of contra-aperture dissection and skin bridge preservation.Results The scores of pain and exudate were significantly different between the treatment and the control group(P＜0.01).The wound-healing time was shorter in the treatment group than that in the control group((27.37±8.93) d vs.(32.73±9.45) d,P=0.000).There were significant differences in the anal resting pressure,anal maximal contraction pressure and active systolic pressure between the two groups (t =13.12,10.21,12.10;P＜0.01).There was no significant difference of total effect between the two groups(100％ and 93.3％;x2 =2.07,P＞0.05).Conclusion Contra-aperture dissection and skin bridge preservation can reduce postoperative pain,exudate and fever,shorten wound-healing time and protect anal functions in the treatment of low transphincteric perianal fistula.