瘘管隧道法切除一期缝合术治疗肛瘘的临床疗效

摘要

目的：探讨利用瘘管隧道法切除一期缝合术进行肛瘘治疗的临床疗效。方法方便选取2013年1月—2014年1月期间入住该院治疗肛瘘的120例患者,按治疗方法不同将其随机分为A、B、C 3组各40例,A组采用瘘管隧道切除一期缝合术,B组采用肛瘘切除缝合术,C组采用肛瘘切除术,对比3个组患者创面愈合时间、术后伤疤情况、感染情况以及肛门的括约肌功能恢复等。结果 A、B两组患者手术后伤口的愈合时间分别为(4±11)d和(5±12)d,相比于C组的愈合时间(9±18)d要更短,疤痕也较小,P<0.05；在手术后伤口出现感染情况以及复发情况的比较上,A组1例,B组15例,C组5例,B组又比A、C两组更高,P<0.05；肛门的变形数量方面A组2例,B组3例,C组18例,A、B两组明显比C组少,P<0.05；另外,A、B两组患者都没有出现因为肛门括约肌损伤而导致大小便时常的病例。结论治疗肛瘘疾病采用瘘管隧道法切除一期缝合术,有效减少了患者伤口创面痊愈的时间,且手术后的疤痕比较小,手术复发率低,最大限度的保护了患者肛门括约肌的功能,提高治疗肛瘘的疗效,值得在临床上广泛推广和应用。%Objective To study the fistula tunnel method is used to suture the first phase of treatment for anal fistula of clinical efficacy. Methods Convenient selection between January 2013 to January 2014 during the period of stay in the hos-pital for the treatment of anal fistula, 120 patients in treatment methods, based on the random divided into A, B, C three groups (40 cases, group A with fistula tunnel suture issue, group B with anal fistula resection decompression, group C with anal fistula resection, compare the three groups of patients with wound healing time, postoperative scar size, postoperative wound infection situation and anal deformation of anal sphincter function, and the postoperative recurrence 2 years of fol-low-up, and statistical analysis. Results A, B two groups of patients after surgical wound healing time was (4±11)d and (5± 12)d,compared to the healing time of group C (9±18)d to be shorter, postoperative scar small,(P<0.05);After surgery wound infections and the comparison of relapse, 1 case of group A, B group of 15 cases, 5 cases of group C, group B was higher than A and C in the two groups,(P< 0.05), Anal the deformation quantity of 2 cases of group A, group B (3 cases), 18 cases of group C,the deformation of group A and group B patients postoperative anal number less than group C (P< 0.05), group A and group B no anal sphincter damage occurred postoperative incontinence. Conclusion The treatment of anal fistula fis-tula tunnel method is used to suture a period, can shorten the wound healing time, postoperative scar small, surgery recur-rence rate is low, the maximum protection for patients with anal sphincter function, improve the curative effect of treatment of anal fistula, is worth in the clinical application and spread.