目的 探讨抗结核治疗和手术治疗肺结核病人伴发结核性肛瘘的时机选择及临床疗效分析.方法 回顾性分析肺结核病人伴发结核性肛瘘52例的临床资料,根据抗结核治疗前后手术时机的选择分为先手术后抗结核治疗组(A组)26例和先抗结核治疗后手术组(B组)26例,进行临床相关指标的对比分析.结果 两组病人在性别、年龄、民族、病程、随访时间上均差异无统计学意义(P>0.05).B组肛瘘治疗总体有效率为100.00%,明显高于A组的76.92%.B组术后相关指标如术后疼痛评分、术后疼痛时间、术后愈合时间及复发率差异有统计学意义(P<0.05),明显优于A组;但在肛门括约肌功能及生活质量评分上差异无统计学意义(P>0.05).结论 肺结核病人伴发结核性肛瘘时,抗结核治疗前后的手术时机选择与病人预后有一定关系,先抗结核治疗后手术治疗可能对改善病人的预后有帮助.%Objective The purpose of this study was to investigate the clinical curative effect of the timing of anti-tuberculosis treatment and surgical treatment in the treatment of tuberculous anal fistula in pulmonary tuberculosis patients.Methods Clinical data of 52 pul-monary tuberculosis patients with tuberculous anal fistula were evaluated according to the choice of operation time.Patients were divided into two groups undergoing surgery before anti-tuberculous treatment (group A)and surgery after anti-tuberculous treatment(group B). Clinic alanalysis was performed using correlation index.Results There were no statistical significances(P>0.05)between the two groups in gender,age,ethnic,duration,follow-up time.Total effective rate of anal fistula in group B was 100.00%,it was significantly higher than group A of 76.92%.There were statistical significances(P<0.05)between the two groups in the aspects of postoperative pain score,postoperative pain time,postoperative healing time and recurrence rate.However,there were no statistical significances(P>0.05)between the two groups in anal sphincter function score and life quality score.Conclusions Anti-tuberculous treatment before surgery may improve the prognosis of tuberculous accompanied with anorectal fistula.
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