Gao Hengqing, Cheng Xiaohong, Gao Lijuan, Wang Wei, Wang Xiaoqiang, Gong Furao, Zhang Mengmeng, Hu Jing
Department of Anorectal, Zigong Hospital of Chinese Traditional Medicine Zigong 643010, Sichuan Province, China.
Department of Pharmacy Zigong Hospital of Chinese Traditional Medicine Zigong 643010, Sichuan Province, China.
Am J Transl Res. 2021 Oct 15;13(10):11737-11744. eCollection 2021.
To investigate the treatment of high complex anal fistula with time-scheduled dotted and solid thread-ligating therapy combined with vacuum sealing drainage.
A retrospective cohort study of 80 patients with high complex anal fistula admitted to the anorectal department of our hospital was conducted. The patients in the control group (n=40) were treated with traditional incision thread-ligating therapy, while the patients in the observation group (n=40) were treated with time-scheduled dotted and solid thread-ligating therapy combined with vacuum sealing drainage. The postoperative wound healing time, clinical efficacy, postoperative pain scores as well as pre- and postoperative anal function and anorectal pressure of patients in the two groups were observed.
The observation group had a shorter wound healing time (P<0.001), lower postoperative pain scores (P<0.05), a lower increase of Wexner score (P<0.001), a higher total effective rate (97.50% vs. 90.00%; P>0.05), a higher anal maximal contraction pressure and a larger high pressure zone than the control group (P<0.05). Compared with those before operation, the Wexner scores of patients in the two groups after operation were increased, while the anal maximal contraction pressure and high pressure zone in the control group were decreased (P<0.001).
The treatment of complex high anal fistula with time-scheduled dotted and solid thread-ligating combined with vacuum sealing drainage has short wound healing time, high efficiency, and little influence on the postoperative function of anal sphincter. It is worthy to be popularized in clinic.
探讨分期虚实挂线疗法联合封闭负压引流治疗高位复杂性肛瘘的疗效。
对我院肛肠科收治的80例高位复杂性肛瘘患者进行回顾性队列研究。对照组(n = 40)采用传统切开挂线疗法,观察组(n = 40)采用分期虚实挂线疗法联合封闭负压引流。观察两组患者术后创面愈合时间、临床疗效、术后疼痛评分以及术前、术后肛门功能和肛管压力。
观察组创面愈合时间短(P < 0.001),术后疼痛评分低(P < 0.05),Wexner评分升高幅度小(P < 0.001),总有效率高(97.50% 比 90.00%;P > 0.05),肛门最大收缩压和高压区大于对照组(P < 0.05)。与术前比较,两组患者术后Wexner评分均升高,对照组肛门最大收缩压和高压区降低(P < 0.001)。
分期虚实挂线联合封闭负压引流治疗高位复杂性肛瘘创面愈合时间短、疗效高,对肛门括约肌术后功能影响小,值得临床推广。