临床外科杂志 ›› 2020, Vol. 28 ›› Issue (1): 69-72.doi: 10.3969/j.issn.1005-6483.2020.01.021

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改进经括约肌间瘘管结扎术治疗复杂性肛瘘的近期疗效及对肛门功能的影响

  

  1. 408300 重庆市垫江县中医院肛肠科
  • 出版日期:2020-01-20 发布日期:2020-01-20
  • 通讯作者: 雷晓梅,Email:505105036@qq.com

Influence of different kinds of LIFT on clinical efficacy for short-term and anal function of patients with complex anal fistula

  1. Department of Anorectal,Dianjiang County Hospital of Traditional Chinese medicine,Chongqing 408300,China
  • Online:2020-01-20 Published:2020-01-20

摘要: 目的 探讨常规和改进经括约肌间瘘管结扎(LIFT)术对复杂性肛瘘病人近期疗效及肛门功能的影响。方法 我院2016年2月~2018年2月收治复杂性肛瘘病人94例,以随机数字表法分为对照组(47例)和改进组(47例),分别采用常规LIFT术和改进LIFT术治疗;比较两组手术相关临床指标、近期疗效、术后疼痛VAS评分、手术前后肛门失禁 Wexner 评分、手术前后肛门直肠压力及术后并发症发生率。结果 两组手术相关临床指标比较差异均无统计学意义(P>0.05);对照组和改进组总治愈率分别为76.60%和93.62%;改进组近期疗效优于对照组,差异有统计学意义(P<0.05);两组术后VAS疼痛评分和术后肛门失禁 Wexner 评分比较差异均无统计学意义(P>0.05);两组手术前后肛门直肠压力水平组间比较差异均无统计学意义(P>0.05);对照组肌间切口裂开感染和括约肌间瘘管发生率分别为25.53%和14.89%;改进组分别为14.89%和4.26%,两组比较差异有统计学意义(P<0.05)。结论 改进LIFT术治疗复杂性肛瘘可提高总体疗效,促进病变愈合,降低术后并发症发生风险,且未影响肛门功能。

关键词: 经括约肌间瘘管结扎术, 复杂性肛瘘, 近期疗效, 肛门功能

Abstract: Objective To investigate the influence of conventional and modified LIFT on clinical efficacy for short-term and anal function of patients with complex anal fistula.Methods 94 patients with complex anal fistula were chosen in the period from January 2016 to January 2018 in our hospital and randomly divided into two groups including control group(47 patients)with conventional LIFT operation and modified group(47 patients)with modified LIFT operation;and the surgery-related clinical indicators,clinical efficacy for short-term,pain VAS score after operation,Wexner score of anal incontinence before and after surgery,anal and rectal pressure before and after surgery and complications incidence after surgery of both groups were compared.Results There was no significant difference in the surgery-related clinical indicators between 2 groups (P>0.05).The clinical efficacy for short-term of control group and modified group were separately 76.60%,93.62%.The clinical efficacy for shortterm of modified group were significant better than control group(P<0.05).There was no significant difference in the pain VAS score after operation and Wexner score of anal incontinence after surgery between 2 groups (P>0.05).There was no significant difference in the anal and rectal pressure before and after surgery between 2 groups (P>0.05).The incidence of intermuscular incision dehiscence infection and sphincter fistula of control group were separately 25.53%,14.89%.The incidence of intermuscular incision dehiscence infection and sphincter fistula of modified group were 14.89%,4.26%.The incidence of intermuscular incision dehiscence infection and sphincter fistula of modified group were significant lower than control group(P<0.05).Conclusion Compared with conventional LIFT,modified LIFT in the treatment of patients with complex anal fistula can efficiently improve the overall clinical effect,promote the healing process of lesions,reduce the postoperative complications risk and not affect anal function.

Key words: ligation of intersphincter fistula, complex anal fistula, clinical efficacy for short-term, anal function

[1] 张明府, 吴永丰, 柳东. 腹腔镜直肠癌前切除术中保留左结肠动脉对术后吻合口漏及近期疗效的影响[J]. 临床外科杂志, 2019, 27(5): 400-403.
[2] 鲁林源, 曹永清, 张强, 卢丹, 赵向东. 视频辅助治疗手术对复杂性肛瘘病人症状及预后的影响[J]. 临床外科杂志, 2019, 27(12): 1041-1043.
[3] 马人杰 贺琦 张海伟 张俊华 郑荣. 腹腔镜完全腹膜外补片植入术治疗腹股沟疝的近期疗效及安全性观察[J]. 临床外科杂志, 2018, 26(11): 862-864.
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