微创另路挂线术治疗高位蹄形肛瘘的临床效果观察

摘要

Objective To observe the clinical effect of minimally invasive thread-drawing operation via another approach on high horseshoe anal fistula.Methods Seventy-six patients with high horseshoe anal fistula patients were divided into minimally invasive group and control group according to the random number table,with 38 cases in each group.The minimally invasive group received minimally invasive thread-drawing operation via another approach,while the control group received conventional arc-incision drainage.The intraoperative blood loss, operation duration and incision healing time as well as postoperative external anal sphincter electromyography,anal function,pain score,anal drainage score,ankyloproctia degree and anal incontinence score were compared between two group.Results The minimally invasive group gained higher contraction and resting amplitudes of external anal sphincter as well as less myoelectric interval of external anal sphincter after operation compared with control group(all P<0.05).The pain score and anal drainage score six days after operation of minimally invasive group were less than those of control group(P<0.05).There was no significant difference in the postoperative ankyloproctia degree or postoperative anal incontinence score between two groups(P >0.05).Conclusion Minimally invasive thread-drawing operation via another approach achieves favorable effects on high horseshoe anal fistula with less trauma,which might effectively protect the perianal tissues and promote the recovery of anal function.%目的：观察微创另路挂线术治疗高位蹄形肛瘘的临床效果。方法将高位蹄形肛瘘患者76例，按照随机数字表法分为微创组与对照组，每组38例，微创组行微创另路挂线术治疗，对照组行常规的弧形切开引流术。对比两组术中出血量、手术时间、切口愈合时间、术后肛门外括约肌肌电图、肛门功能、疼痛积分、肛门渗液积分、肛门狭窄程度积分、肛门失禁积分。结果微创组术后肛门外括约肌收缩波幅、静息波幅均高于对照组（P均＜0．05），肛门外括约肌肌电时程低于对照组（P＜0．05），术后6 d疼痛积分、肛门渗液积分少于对照组（P＜0．05），两组术后肛门狭窄程度积分、肛门失禁积分与对照组比较，差异无统计学意义（ P＞0．05）。结论微创另路挂线术治疗高位蹄形肛瘘效果好，创伤小，能有效保护肛周组织，促进肛门功能恢复。