经括约肌间瘘管结扎术治疗高位单纯性肛瘘的临床疗效

Clinical efficacy of ligation of intersphincteric fistula tract for the treatment of high anal fistula

    摘要
  • 摘要:
    目的 评估经括约肌间瘘管结扎术(LIFT)治疗高位单纯性肛瘘的临床疗效。方法 回顾性分析2011年1月至2012年6月北京普仁医院与北京朝阳医院收治的77例高位单纯性肛瘘患者的临床资料，患者分别采用LIFT手术法(LIFT组，37例)和切开挂线法(切开挂线组，40例)进行治疗，对两组患者的手术时间、创口愈合时间、术后疼痛时间及严重程度、复发率及对肛门功能影响等进行对照分析。正态分布的计量资料采用t检验，非正态分布的计量资料及等级资料采用秩和检验，计数资料采用χ2检验。结果LIFT组和切开挂线组患者手术时间分别为(21.4±2.0)min及(20.6±1.9)min，两组比较，差异无统计学意义(t=1.911，P>0.05)。术后LIFT组仅17例感轻度疼痛，无中度以上疼痛；切开挂线组轻度疼痛7例、中度疼痛14例、重度疼痛19例；LIFT组疼痛持续时间为(3.0±1.3)d，切开挂线组为(14.1±1.5)d；LIFT组在术后疼痛程度及持续时间均明显低于切开挂线组，差异有统计学意义(u=-7.189，t=34.534，P<0.05)。LIFT组和切开挂线组创口愈合时间分别为(26.0±1.9)d和(40.7±2.8)d，肛门瘢痕面积分别为(1.24±0.20)cm2和(2.64±0.25)cm2，术后中位肛门功能评分分别为1分和4分，两组比较，差异均有统计学意义(t=26.574，26.868，Z=-7.513，P<0.05)。两组患者治疗有效率均为100%，LIFT组和切开挂线组患者痊愈率分别为51.4%(19/37)和42.5%(17/40)，复发率分别为5.4%(2/37)和2.5%(1/40)，两组痊愈率、复发率比较，差异均无统计学意义(χ2=0.605，0.433，P>0.05)。结论 高位单纯性肛瘘行LIFT治愈率高，术后疼痛轻且持续时间短，创口愈合快，肛门功能保护好，复发率低。

     

    Abstract:
    Objective To investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) for the treatment of high anal fistula. Methods The clinical data of 77 patients with high anal fistula who were admitted to the Puren Hospital and Chaoyang Hospital from January 2011 to June 2012 were retrospectively analyzed. All the patients were treated using the LIFT method (LIFT group, 37 patients) or fistulectomy+threaddrawing therapy (thread drawing group, 40 patients). The operation time, healing time, time and severity of postoperative pain, recurrence and anal sphincter dysfunction were compared between the 2 groups. The measurement data, the count data and the rank data were analyzed using the t test, chi-square test, and the rank sum test, respectively. Results The operation time of the LIFT group and the threaddrawing group were (21.4±2.0)minutes and (20.6±1.9)minutes, with no significant difference between the 2 groups (t=1.911, P>0.05). In the LIFT group, 17 patients felt low grade pain, no patient felt mediumgrade or severe pain. In the threaddrawing group, 7 patients felt lowgrade pain, 14 patients felt mediumgrade pain, 19 patients felt severe pain. The duration of postoperative pain in the LIFT group and the threaddrawing group were (3.0±1.3)days and (14.1±1.5)days, respectively. The severity and duration of postoperative pain of the LIFT group were significant lower and shorter than those of the threaddrawing group (u=-7.189, t=34.534, P<0.05). The healing time, anal scar area and anal sphincter function score were (26.0±1.9)days, (1.24±0.20)cm2 and 1 in the LIFT group, and (40.7±2.8)days, (2.64±0.25)cm2 and 4 in the threaddrawing group, with no significant difference between the 2 groups (t=26.574, 26.868, Z=-7.513, P<0.05). The effective rate of the 2 treatment methods were 100%. The cure rate and recurrence rate were 51.4%(19/37) and 5.4%(2/37) in the LIFT group, and 42.5%(17/40) and 2.5%(1/40) in the thread drawing group. There were no significant differences in the cure rate and recurrence rate between the 2 groups (χ2=0.605, 0.433, P>0.05). Conclusion  LIFT method has higher cure rate for high anal fistula with short time of postoperative pain and healing, good anal sphincter function and low recurrence rate.

     

    • HTML全文
    • 参考文献(0)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回