天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (5): 534-538.doi: 10.11958/20203452

• 临床研究 • 上一篇    下一篇

2种经括约肌间入路术式治疗高位单纯性肛瘘的对比分析

郭高正1，郑雪平2△，谭妍妍2，徐大超2，曹磊2，皇甫少华2，王兴宝2   

  1. 1南京中医药大学（邮编210009）；2南京中医药大学附属南京中医院肛肠中心
  • 收稿日期:2020-12-14 修回日期:2021-01-23 出版日期:2021-05-15 发布日期:2021-05-25
  • 通讯作者: 郑雪平 E-mail:dyjc1028@163.com
  • 基金资助:
    南京市“十三五”规划名中医工作室建设项目（ZXP-2019-NJ）

Comparative analysis of two kinds of intersphincter approach in the treatment of high simple anal fistula#br#

GUO Gao-zheng1, ZHENG Xue-ping2△, TAN Yan-yan2, XU Da-chao2, CAO Lei2, HUANGFU Shao-hua2, WANG Xing-bao2   

  1. 1 Nanjing University of Traditional Chinese Medicine, Nanjing 210009, China; 2 Department of Anorectal Center, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine
  • Received:2020-12-14 Revised:2021-01-23 Published:2021-05-15 Online:2021-05-25

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摘要：

摘要：目的　观察2种经括约肌间入路术式治疗高位单纯性肛瘘的临床疗效。方法　采用随机数字表法将72例高位单纯性肛瘘患者分为试验组（36例）和对照组（36例），试验组采用改良经肛括约肌间切开术（TROPIS术）治疗，对照组采用经括约肌间瘘管结扎术（LIFT术）治疗，比较2组的住院时间、手术时间、治愈率、肛门功能、疼痛指数、创面面积、术后并发症及临床疗效。结果　试验组手术时间较对照组缩短，且治愈率高于对照组（P＜0.05）；2组住院时间、手术前后肛门功能及创面面积方面差异均无统计学意义。在术后第1、3、7天3个时间点试验组疼痛指数均低于对照组（P＜0.05）；对照组并发症总发生率高于试验组，手术有效率低于试验组（P＜0.05）。结论　改良TROPIS术可提高治愈率、缩短手术时间、减轻术后疼痛、减少术后并发症的发生，值得推广应用于临床。

关键词: 直肠瘘, 手术后并发症, 高位单纯性肛瘘, 保留括约肌术式, 经括约肌间入路, 临床疗效

Abstract:

Abstract: Objective　To observe the clinical efficacy of two kinds of intersphincter approach in the treatment of high simple anal fistula. Methods　Seventy-two patients with high simple anal fistula were randomly divided into experimental group (n=36) and control group (n=36). The experimental group was treated with TROPIS (modified transanal opening of intersphincteric space), and the control group was treated with LIFT (ligation of the intersphincteric fistula tract). The hospitalization time, operation time, cure rate, anal function, pain index, wound area, postoperative complications and clinical effect were compared between the two groups. Results　The operation time was shorter in the experimental group than that of control group, and the cure rate was higher than that of control group (P＜0.05). There were no significant differences in length of hospital stay, anal function and wound area before and after operation between the two groups. The pain index values were lower at the first, third and seventh day after surgery in the experimental group than those of the control group (P＜0.05). The total incidence of complications was higher in the control group than that in the experimental group, and the operative efficiency was lower than that in the experimental group (P＜0.05). Conclusion　The modified TROPIS operation can increase cure rate, shorten the operation time, reduce postoperative pain and reduce postoperative complications, which is worthy of being popularized in clinical application.

Key words: rectal fistula, postoperative complications, high simple anal fistula, sphincter preserving operation, transsphincter approach, clinical effect