高位复杂性经括约肌性肛瘘 经括约肌间肛瘘结扎术医治高位肛瘘的临床研讨

王菁++石荣++黄娟

[摘要]意图 研讨经括约肌间肛瘘结扎术医治高位肛瘘的临床作用。办法 选取我院2013年10月～2015年5月的60例高位经括约肌肛瘘患者，依照随机数字表法分红医治组和对照组，各30例。医治组选用经括约肌间肛瘘结扎术，对照组选用传统切开挂线术。调查两组的住院时刻、创面愈合时刻，别离于术前1 d及术后第3个月点评患者的肛门功用状况。成果 两组均顺利完成手术，两组的手术时刻、治愈率、复发率、随访时刻、大便失禁例数比较，差异无统计学含义（P>0.05）。医治组的重返日常活动时刻、住院天数和创面愈合时刻短于对照组，差异有统计学含义（P<0.05）。两组术后3个月的Wexner分值、肛管最大缩短压、肛管静息压、直肠最小感觉容量、初始排便容量、最大耐受容量、最大缩短波幅优于医治前，医治组术后3个月的Wexner分值、肛管最大缩短压、肛管静息压、直肠最小感觉容量、初始排便容量、最大耐受容量、最大缩短波幅优于对照组，差异有统计学含义（P<0.05）。定论 与传统切开挂线术比较，经括约肌间肛瘘结扎术的住院天数短，愈合时刻短，能更快地重返日常活动，能够在确保治愈率前提下又能更好地维护肛门括约肌功用，具有重要的临床含义。

[关键词]经括约肌间肛瘘结扎术；高位肛瘘；肛门功用；临床研讨

[中圖分类号] R657.1+6 [文献标识码] A [文章编号] 1674-4721（2017）08（b）-0014-04

Clinical study of ligation of intersphincteric fistula tract in the treatment of high anal fistula

WANG Jing SHI Rong▲ HUANG Juan

Department of Anorectal Surgery，People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine，Fujian Province，Fuzhou 350004，China

[Abstract]Objective To study the clinical efficacy of ligation of intersphincteric fistula tract in the treatment of high anal fistula.Methods From October 2013 to May 2015，60 patients with high sphincter anal fistula in our hospital were selected and divided into the treatment group （n=30） and the control group （n=30） according to random number table method.The treatment group was treated with ligation of intersphincteric fistula tract，and the control group was given the traditional incision and thread technique.The time of hospitalization and wound healing were observed in the two groups.The anus function was evaluated at 1 day before operation and 3 months after operation.Results The two groups completed the operation successfully，there were no significant differences in the operation time，cure rate，recurrence rate，follow-up time and the number of fecal incontinence between the two groups （P>0.05）.The time to return to routine activities，hospitalization and wound healing time in the treatment group was shorter than that in the control group，with significant difference （P<0.05）.The Wexner score，maximum systolic pressure of anal canal，anal canal rest pressure，rectal minimum sensory capacity，initial defecation capacity，maximum tolerance capacity and maximum systolic amplitude in the two groups at 3 months after treatment was better than that before treatment，the Wexner score，maximum systolic pressure of anal canal，anal canal rest pressure，rectal minimum sensory capacity，initial defecation capacity，maximum tolerance capacity and maximum systolic amplitude in the treatment group at 3 months after treatment was better than that in the control group，with significant difference （P<0.05）.Conclusion Compared with the traditional incision and thread technique，ligation of intersphincteric fistula tract can shorten hospitalization and healing time，which can return to daily activities faster，can ensure the cure rate and better protect the anal sphincter function，so it has important clinical significance.endprint