肛瘘切开引流治疗肛瘘的疗效及患者手术前后肛肠动力学变化特点

摘要

目的 探讨肛瘘切开引流治疗肛瘘的疗效及患者手术前后肛肠动力学变化特点.方法 选取2013年3月至2015年2月我院收治的高位复杂性肛瘘患者84例为研究对象,采用随机数表法分为观察组和对照组各42例,对照组采取常规脓肿切开引流术,观察组采取肛瘘切开引流术,比较两组治疗有效率,采用肛肠测压仪检测两组肛管最大收缩压(AMCP)、肛管最长收缩时间(ALCT)、直肠静息压(RRP)、肛管静息压(ARP),同时记录6个月复发率.结果 观察组治疗有效率高于对照组(95.2％ vs.81.0％;P＜ 0.05).治疗前后两组AMCP、ALCT、RRP、ARP比较均无统计学差异(P＞0.05).术后6个月观察组复发率低于对照组(2.4％ vs.14.3％;P＜0.05).结论 肛瘘切开引流可有效治疗肛瘘,且对患者肛肠动力学影响小,值得在临床推广应用.%Objective To explore the efficacy of anal fistula incision and drainage in the treatment of anal fistula and change characteristics of patients' anorectal dynamics before and after the operation.Methods 84 cases of high complex anal fistula treated in our hospital from March 2013 to February 2015 were selected as the research objects,and divided into observation group and control group by the random number table,42 cases in each group.Control group received routine abscess incision and drainage operation,while observation group received anal fistula incision and drainage operation.The effective rate of treatment in two groups were compared,anorectal pressure measuring instrument was used to detect anal maximal contraction pressure (AMCP),anal longest contraction time (ALCT),rectal resting pressure (RRP),and anal resting pressure (ARP) in two groups,the recurrence rate in 6 months was recorded.Results The effective rate of treatment in observation group was significantly higher than that in control group (95.2％ vs.81.0％,P＜0.05).There were no statistically significant differences in AMCP,ALCT,RRP,ARP between two groups before and after treatment (P＞0.05).The recurrence rate in 6 months in observation group was significantly lower than that in control group (2.4％ vs.14.3％,P＜0.05).Conclusion Anal fistula incision and drainage can treat anal fistula effectively,with little effect on patients' anorectal dynamics,with value of clinic application.