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隧道浮线引流联合放射状切口治疗高位后马蹄形肛瘘及肛周菌群的疗效：随机对照试验。

Efficacy of radial incision combined with tunnel floating line drainage in the treatment of high posterior horseshoe anal fistula and perianal flora: Randomized control trial.

机构信息

Huazhong Agricultural University Hospital, Wuhan, Hubei, P. R. China.

Department of Anorectal Surgery, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, Hubei, P. R. China.

出版信息

Medicine (Baltimore). 2024 Oct 11;103(41):e39947. doi: 10.1097/MD.0000000000039947.

DOI:10.1097/MD.0000000000039947
PMID:39465802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11479427/
Abstract

BACKGROUND

Due to the high prevalence of posterior horseshoe anal fistula and causing numerous complications, this study aimed to investigate the clinical effect of radial incision combined with tunnel floating line drainage (RCTD) and arc incision internal drainage in the treatment of the disease and the influence on perianal flora.

METHODS

Ninety-six subjects treated with high posterior horseshoe anal fistula were stochastically assigned to a joint group (RCTD), and control group (arc incision internal drainage). The operation-related conditions, complication rate, anal function, and recurrence rate of 6 months after operation were compared, and perianal secretions were collected before operation and 1 day after operation to detect the changes of microbial flora.

RESULTS

After operation, it was corroborated notable difference between joint group and control group in operation time, intraoperative blood loss, wound healing time, visual analogue scale score 6 hours after operation and phase I cure rate. Chi square test analysis showed notable difference between control group (27.08%) and joint group (10.40%) in incidence of complications, in terms of number of pathogens detected around anus, significantly smaller of the incremental change for the joint subgroup versus the control subgroup 1 day after operation.

CONCLUSION

RCTD can be the best choice for patients with high posterior horseshoe anal fistula. This operation method has the advantages of short operation time, less trauma, fewer complications, fast recovery of anal function, and can also reduce perianal pathogenic bacteria infection.

摘要

背景

由于后马蹄形肛瘘的高发病率和众多并发症，本研究旨在探讨放射状切口联合隧道浮线引流（RCTD）与弧形切口内引流治疗该病的临床效果及对肛周菌群的影响。

方法

将 96 例高位后马蹄形肛瘘患者随机分为联合组（RCTD）和对照组（弧形切口内引流）。比较两组患者的手术相关情况、并发症发生率、肛门功能、术后 6 个月复发率，术前及术后 1 天采集肛周分泌物，检测微生物菌群变化。

结果

术后，联合组与对照组在手术时间、术中出血量、伤口愈合时间、术后 6 小时视觉模拟评分和一期治愈率方面均有显著差异。卡方检验分析显示，对照组（27.08%）与联合组（10.40%）的并发症发生率有显著差异，联合组术后 1 天肛门周围检出的病原体数量明显少于对照组。

结论

RCTD 可作为高位后马蹄形肛瘘患者的最佳选择。该手术方法具有手术时间短、创伤小、并发症少、肛门功能恢复快的优点，还可降低肛周病原菌感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/3d79ac575e0e/medi-103-e39947-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/855fe93b3384/medi-103-e39947-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/ea6fe0db4618/medi-103-e39947-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/38c78dce7b0d/medi-103-e39947-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/442f9cff175c/medi-103-e39947-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/3d79ac575e0e/medi-103-e39947-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/855fe93b3384/medi-103-e39947-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/ea6fe0db4618/medi-103-e39947-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/38c78dce7b0d/medi-103-e39947-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/442f9cff175c/medi-103-e39947-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f8/11479427/3d79ac575e0e/medi-103-e39947-g005.jpg

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Differences in Gut Microbiota between Healthy Individuals and Patients with Perianal Abscess before and after Surgery.健康个体与肛周脓肿患者手术前后肠道微生物组的差异。
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