改良LIFT术治疗中青年复杂性肛瘘的临床效果研究

摘要

目的 观察改良括约肌间瘘结扎术(改良LIFT术)及单纯LIFT术治疗中青年复杂性肛瘘的临床效果.方法 选择本院82例中青年复杂性肛瘘患者随机分为观察组(行改良LIFT术)与对照组(行单纯LIFT术),每组各41例.比较两组手术相关指标(手术时间、术中出血量、禁食时间、创面愈合时间、住院时间)、手术治疗效果、术后肛门功能及并发症发生率.结果 观察组创面愈合时间(16.31±2.58) d、住院时间(5.35±1.34) d短于对照组,差异均有统计学意义(均P ＜ 0.05).两组手术时间、术中出血量、禁食时间差异均无统计学意义(均P ＞ 0.05).两组总有效率均为100％.观察组痊愈率90.24％,高于对照组的73.17％,差异有统计学意义(P＜ 0.05).两组术后7 d、1个月、3个月、6个月肛门失禁评分均呈降低趋势(均P ＜ 0.05),组间各时点差异均无统计学意义(均P ＞0.05).两组并发症发生率差异无统计学意义(P ＞ 0.05).结论 改良LIFT术与单纯LIFT术治疗中青年复杂性肛瘘对肛门功能损伤小,安全可靠,但前者治愈率更高,可缩短愈合时间及住院时间,值得在临床推广使用.%Objective To investigate the clinical value of modified anal sphincter ligation (modified LIFT) and simple LIFT in the treatment of complicated anal fistula in young and middle-aged patients. Methods 82 young patients with complex anal fistula treated in our Hospital were randomly assigned to treatment group (modified LIFT operation) and control group (simple LIFT therapy), with 41 patients in each group. Indices related to operation (operative duration, blood loss, fasting time, time to wound healing, hospitalization duration), treatment effect, postoperative anal function and complication rate were compared between the two groups. Results Time to wound healing (16.31 ± 2.58) d, hospitalization duration (5.35 ± 1.34) d were shorter in the treatment group than that in the control group, with statistically significance (P ＜ 0.05). There was no significant difference in operation duration, blood loss and fasting time between the two groups (P ＞ 0.05). The total effective rate was 100％ in the two groups. The cure rate was 90.24％ in the treatment group, which was higher than that in the control group (73.17％, P ＜ 0.05). 7 d, 1 months, 3 months, and 6 months after operation, the scores of anal incontinence decreased in both groups, with no significant difference (P ＞ 0.05). The complication rate of the two groups was similar (P ＞ 0.05). Conclusion Modified LIFT and simple LIFT is safe and effective in the treatment of complex anal fistula in young and middle-aged patients. It induces less anal injury, has a higher cure rate, and shortens time to healing and hospital duration. It has value in clinical application.