Beck D E, Fazio V W, Lavery I C, Jagelman D G, Weakley F L
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio.
South Med J. 1988 Apr;81(4):444-6. doi: 10.1097/00007611-198804000-00008.
We retrospectively reviewed the charts of 55 patients with ischiorectal abscesses treated from 1980 to 1983 at the Cleveland Clinic Foundation. The patients were treated by placement of a 10F to 16F soft latex mushroom catheter into the abscess cavity under local anesthesia as an office procedure. The end of the catheter was shortened to leave 2 to 3 cm exiting the skin, and a bandage was applied. No sutures or irrigations were used, and the drains were removed an average of 12 days after placement. Antibiotics were not given. The patients ranged in age from 17 to 76 years (mean, 40 years) and 36% were female. Four patients had diabetes, and eight had a history of inflammatory bowel disease. Nine patients had been treated previously for anorectal abscesses. There were no complications. Adequate follow-up was obtainable in 31 patients (ten to 63 months; mean, 30 months). Eight of them (26%) were subsequently treated for fistulas found after resolution of the abscess, and an additional eight (26%) had a second abscess form during the follow-up period. The average time to this recurrence was 20 months. Catheter drainage of ischiorectal abscess in selected cases resulted in healing with low morbidity and significant cost savings.
我们回顾性研究了1980年至1983年在克利夫兰诊所基金会接受治疗的55例坐骨直肠窝脓肿患者的病历。这些患者在局部麻醉下作为门诊手术，通过将一根10F至16F的软乳胶蘑菇导管置入脓肿腔内进行治疗。导管末端缩短，使其露出皮肤2至3厘米，并进行包扎。未使用缝线或冲洗，引流管平均在放置后12天拔除。未使用抗生素。患者年龄在17岁至76岁之间（平均40岁），36%为女性。4例患者患有糖尿病，8例有炎症性肠病病史。9例患者曾接受过肛管直肠脓肿治疗。无并发症发生。31例患者获得了充分的随访（10至63个月；平均30个月）。其中8例（26%）在脓肿消退后因发现肛瘘而接受治疗，另外8例（26%）在随访期间出现了第二个脓肿。这种复发的平均时间为20个月。在选定病例中，坐骨直肠窝脓肿的导管引流可实现愈合，发病率低且显著节省成本。
