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疗效与预后:引流皮桥保留术联合瘘管切开术与单纯瘘管切开术治疗肛瘘的效果比较。

Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula.

机构信息

Department of Anorectal Surgery, The First People's Hospital of Fuyang Hangzhou, Hangzhou, Zhejiang 311400, China.

出版信息

J Healthc Eng. 2021 Nov 28;2021:6940072. doi: 10.1155/2021/6940072. eCollection 2021.

Abstract

OBJECTIVE

This study intends to analyze the difference in the efficacy of drainage skin-bridge sparing surgery combined fistulotomy (DSCF) and fistulotomy alone.

METHODS

125 patients with anal fistula were enrolled as study subjects and randomly divided into control group (CG) and observation group (OG) by double-blind lottery. The CG received drainage skin-bridge sparing surgery with fistulotomy and the OG received fistulotomy only.

RESULTS

The VAS scores of the trauma in the OG were lower than those in the CG on 1st day of surgery and 7 days after surgery ( < 0.05). The length of hospital stay and time to wound healing were shorter in the OG than in the CG ( < 0.05). The incidence of postoperative bleeding in the OG was 9.52%, which was lower than 22.58% in the CG ( < 0.05). The rectal examination scores were lower in the OG than in the CG at 3 and 5 days postoperatively ( < 0.05). The Wexner scores of solid incontinence (0 to 4), liquid incontinence (0 to 4), gas incontinence (0 to 4), pad wearing (0 to 4), and lifestyle alteration (0 to 4) in the OG were lower than those of the CG at 5 days postoperatively ( < 0.05). Voiding function scores were lower in the OG than in the CG at 2 and 3 days postoperatively ( < 0.05).

CONCLUSIONS

The efficacy of drainage skin-bridge sparing surgery combined fistulotomy is better than that of fistulotomy alone, which can accelerate postoperative healing, enhance urinary function, reduce postoperative bleeding, and improve anal function.

摘要

目的

本研究旨在分析保留引流桥皮手术联合切开术(DSCF)与单纯切开术的疗效差异。

方法

将 125 例肛瘘患者纳入研究对象,采用双盲抽签法分为对照组(CG)和观察组(OG)。CG 行保留引流桥皮切开术,OG 仅行切开术。

结果

OG 组患者术后第 1 天及第 7 天的创伤 VAS 评分均低于 CG 组(<0.05)。OG 组患者的住院时间及创面愈合时间均短于 CG 组(<0.05)。OG 组患者术后出血发生率为 9.52%,低于 CG 组的 22.58%(<0.05)。OG 组患者术后第 3 天及第 5 天的直肠指诊评分均低于 CG 组(<0.05)。OG 组患者术后第 5 天的固体失禁(0-4 分)、液体失禁(0-4 分)、气体失禁(0-4 分)、使用护垫(0-4 分)和生活方式改变(0-4 分)的 Wexner 评分均低于 CG 组(<0.05)。OG 组患者术后第 2 天及第 3 天的排尿功能评分均低于 CG 组(<0.05)。

结论

保留引流桥皮手术联合切开术的疗效优于单纯切开术,可加速术后愈合,增强排尿功能,减少术后出血,改善肛门功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7563/8645410/97d545e583d5/JHE2021-6940072.001.jpg

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