| 摘要: |
| 目的：观察经肛门吻合器瘘管切除术联合橡皮生肌膏治疗直肠黏膜下肛瘘的疗效。方法：将 45 例直肠黏膜下肛瘘患者随机分为 3 组，每组 15 例，第 1 组（STF 组）予以经肛门吻合器瘘管切除术治疗，第 2 组（STF+O 组）予以经肛门吻合器术联合橡皮生肌膏外用治疗，第 3 组（CON 组）予以挂线疗法治疗，比较三组之间手术时间、术后疼痛评分（VAS）、肉芽生长评分、创面愈合时间，记录术前及术后的肛门功能 Williams 评分并进行比较。结果：STF 组手术时间（18.02±5.61） min，STF+O 组手术时间（16.87±5.93）min，均低于 CON 组（23.67±4.81）min（P<0.05）；STF 组第 10 天、20 天VAS 评分分别为（7.01±1.91）分、（4.93±2.74）分，STF+O 组第 10 天、20 天 VAS 评分分别为（7.07±1.98）分、（3.13±2.62）分，均低于 CON 组（8.20±1.66）分、（6.20±2.48）分（P<0.05），STF+O 组第 20 天 VAS 评分低于 STF 组（P<0.05）； STF 组第 10 天、20 天肉芽评分分别为（1.60±0.91）分、（1.20±0.94）分，STF+O 组第 10 天、20 天肉芽评分（1.27±0.96）分、（0.80±0.86）分，均低于 CON 组（1.93±1.10）分、（1.60±1.12）分，STF+O 组第 10 天、第 20 天肉芽评分低于 STF 组（P<0.05）； STF 组、STF+O 组创面愈合时间分别为（36.13±10.63）d、（25.07±6.29）d，均低于 CON 组（47.20±7.62）d（P<0.05）， STF+O 组创面愈合时间低于 STF 组（P<0.05）。术后 3 个月 STF 组、STF+O 组、CON 组Williams 评分均比入院时显著提高（P<0.05），且 STF、STF+O 组显著优于 CON 组（P<0.05）。结论：在经肛门吻合器治疗直肠黏膜下肛瘘基础上，采用橡皮生肌膏治疗能够缩短愈合时间，减轻术后疼痛，不损伤肛门功能，加速康复。 |
| 关键词: 直肠黏膜下肛瘘 橡皮生肌膏 吻合器 瘘管切除术 |
| DOI：10.3969/j.issn.1007-6948.2019.05.008 |
|
| 基金项目: |
|
| Fistulision Combined with Xiangpi Shengji Ointment in Treatment of Rectal Submucous Fistula |
| LI Xin,ZHAO Gang,WANG Ying-ying,CHU Yi |
| Department of Anorectal, the Af?iated Hospital of Qingdao University, Qingdao (226001), China |
| Abstract: |
| Objective To observe the clinical effects of stapled transanal ?stulectomy (STF) combined with Xiangpi Shengji Ointment (XSO) in the treatment of rectal submucous ?stula.Methods Totally 45 patients with this fistula were divided into stapled transanal fistulectomy (STF) group, stapled transanal fistulectomy combined with XSO (STF+ O) group and constrol (CON) group. The patients in STF and STF+O groups were treated with STF, and the patients in STF+O group were treated with XSO from 5 d after operation. The patients in CON group were treated with cutting seton therapy. The operation time, VAS (visual analog score), granulation scores, and time of healing were recorded, the Williams scores were recorded and compared before and after operation. Results The operation time in STF group and STF+O group [(18.02±5.61) min and (16.87±5.93)min] were lower than that in CON group [(23.67±4.81) min] (P<0.05). VAS scores in STF group (7.01±1.91) and STF+O group (7.07±1.98) after operation were lower than that in CON group (8.20±1.66) on day 10 (P<0.05), VAS scores in STF group (4.93±2.74) and STF+O group (3.13±2.62) after operation were lower than that in CON group (6.20±2.48) on day 20 (P<0.05), VAS scores in STF+O group on day 20 after operation was lower than that in STF group (P<0.05). granulation scores in STF group (1.60±0.91) and STF+O group (1.27±0.96) after operation were lower than that in CON group (1.93±1.10) on day 10 (P<0.05), granulation scores in STF group (1.20±0.94) and STF+O group (0.80±0.86) after operation were lower than that in CON group (1.60±1.12) on day 20 (P<0.05), granulation scores in STF+O group on day 10 and 20 after operation were lower than that in STF group (P<0.05).The healing time in STF group [(36.13±10.63) d] and STF+O group [(25.07±6.29) d] were shorter than that in CON group [(47.20±7.62) d] (P<0.05), the healing time in STF+O group was lower than that in STF group (P<0.05).Willams scores in 3 groups after operation at 3 months were significant higher than that before operation, STF group and STF+O group were signi?cantly higher than that in CON group (P<0.05). Conclusion Based on STF for rectal submuscous ?stula, the use of XSO can reduce postoperative pain, shorten the healing time and accerlate recovery. |
| Key words: Rectal submucous ?stula Xiangpi Shengji Ointment anastomat ?stulision |
