一期切开术与一期切除术治疗首发肛周脓肿的临床疗效对比

摘要

Objective:To observe the clinical efficacy of phase Ⅰ incision and phase Ⅰ resection in the treatment of the first-episode perianal abscess.Methods:A total of 80 patients with the first-episode perianal abscess were selected in Jinshan Hospi-tal,Fudan University from Jan 2012 to Dec 2013 and were randomly assigned into incision group(n=40)and resection group (n=40).Patients in incision group were treated by phase Ⅰ incision,while patients in resection group were treated by phase Ⅰresection.The clinical efficacy,wound-healing time,size of the scar,anal function and recurrence in the two groups were ob-served.Results:The overall effective rates were 100% in the two groups,and there was no statistically significant difference in clinical efficacy between the two groups(P >0.05).There were no statistically significant differences between the two groups in postoperative wound-healing time,size of the scar and anal function(P >0.05).However,there were 3 cases that recurred at 6 month after operation in incision group.Conclusions:Both incision and resection could be chosen as phase I radical operation for the first-episode perianal abscess.But incision has certain recurrence rate,which imply that the inflammatory outer wall of peri-anal abscess has certain influence on the postoperative recurrence.%目的：观察一期切开术与一期切除术治疗首发肛周脓肿的临床疗效。方法：选择2012年1月—2013年12月复旦大学附属金山医院收治的80例首发肛周脓肿患者，将其随机分为切开组（n＝40）和切除组（n＝40）。切开组采用一期切开术治疗，切除组采用一期切除术治疗。观察2组临床疗效、术后创面愈合时间、瘢痕面积、肛门功能情况、术后复发情况。结果：切开组、切除组总有效率均为100％，2组临床疗效差异无统计学意义（P ＞0．05）。2组术后创面愈合时间、瘢痕面积及肛门功能情况比较差异均无统计学意义（P ＞0．05），但切开组在术后6个月内3例复发。结论：切开术和切除术均可以作为首发肛周脓肿的一期根治术的术式选择，但切开术有一定的复发率，提示脓肿的炎性外壁对术后复发有一定影响。