摘要
目的探讨分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的安全性和有效性。方法采用随机对照、多中心平行试验的设计方法。共纳入病例240例,试验组120例采用分段开窗旷置结合切扩挂线置管引流术,对照组120例采用切开挂线术,就2组的安全性指标和有效性指标进行对比研究。结果试验组临床痊愈率明显高于对照组(P<0.05),手术时间、创面愈合时间及伤口愈合后瘢痕面积明显短于或小于对照组(P<0.01),术后肛管直肠压力及直肠容量感觉功能降低幅度明显小于对照组(P<0.01),术后直肠肛管反射功能及内口、主管和支管愈合情况优于对照组(P<0.05,P<0.01),术后肛门失禁明显少于对照组(P<0.01)。结论分段开窗旷置结合切扩挂线置管引流术对肛门直肠结构和功能的保护明显优于传统方法,具有治愈率高、伤口愈合时间短、瘢痕面积小、痛苦小等优点,值得作为肛瘘手术的新规范化术式在临床中推广应用。
Objective To investigate the safety and effectiveness of the operation of integrate subparagraph,fenestration,exclusion,cut expansion,seton,tube,and drainage（ISFECSTD） to cure complex anal fistula.Methods Using randomized comparison and multicenter parallel experiment,the total number was 240： 120 patients in study group treated by ISFECSTD,and 120 patients in control group treated by extended cutting and seton operation.Then compared the safety and effectiveness between two groups.Results The clinical recovery rate of the study group was significantly higher than that in the control group（P0.05）.The operation time and wound healing time in study group were significantly less than those in control group,and the scar area after wound healing was smaller than that in control group（P0.01）.The decreased extents of anorectal pressures and rectal capacity feeling function after operation in study group were smaller than those in control group（P0.01）.Rectal and anal reflex function and healing of the endostoma,stem,and branch in study group were better than those in control group（P0.05,P0.01）.Incidence of anal incontinence after operation in study group was significantly less than that in control group（P0.01）.Conclusions The method of ISFECSTD to cure complex anal fistula is better than traditional method in the protection of anus-rectum structure and function,and has the merits of higher cure rate,shorter time of healing,smaller scar,less pain,etc.The method of ISFECSTD is worth being a new standardized operation in the clinical application.
出处
《中国普外基础与临床杂志》
CAS
2010年第12期1270-1274,共5页
Chinese Journal of Bases and Clinics In General Surgery
基金
湖南省教育厅重点基金项目(项目编号:08A051)~~
关键词
分段开窗旷置结合切扩挂线置管引流术
复杂性肛瘘
多中心临床研究
Operation of integrate subparagraph
fenestration
exclusion
cut expansion
seton
tube
and drainage
Complex anal fistula
Multicenter clinical trial
