截径（挂线）隧道式对口浮线引流术治疗高位后蹄铁型肛瘘的临床研究

【作者】 付皓；

【导师】 王晓林；

【作者基本信息】 成都中医药大学 ， 中医外科， 2008， 硕士

【摘要】 目的:观察和评价截径(挂线)隧道式对口浮线引流术治疗高位后蹄铁型肛瘘的术式优劣及临床疗效。方法:将40例高位后蹄铁型肛瘘患者随机分成试验组和对照组,其中试验组20例采用截径(挂线)隧道式对口浮线引流术,对照组20例采用弧形切缝(挂线)内口引流术。观察两组病例的疗效、手术操作性、术后反应及并发症、伤口愈合情况、肛门功能及随访半年内的复发情况等,应用统计学软件SPSS13.0对结果进行分析,以α=0.05为水准进行双侧检验。结果:试验组在手术时间、术中出血、术后第2-4天疼痛、切口水肿等方面明显优于对照组,存在显著性差异(P＜0.05);对照组在愈合时间上明显优于试验组(P＜0.05);而在术后当天疼痛、排尿障碍、术后继发感染、肛门功能、疗效及随访复发情况等方面两组无显著差异(P＞0.05)。而从总体疗效的加权评分来看,两组无统计学差异(P＞0.05)。结论:截径(挂线)隧道式对口浮线引流术在治疗高位后蹄铁型肛瘘上,不仅能达到了根治肛瘘和良好地保护肛门功能的有机统一,而且在术式上有明显的优势如可操作性强,损伤小等,并且有效减少术后并发症的发生,证明了截径(挂线)隧道式对口浮线引流术是治疗高位后蹄铁型肛瘘的优良术式。更多还原

【Abstract】 Objective:To observe and assess the therapeutic effect of the modus operandi with intercept the trail,tie the muscle and with a floating-rubber tissue in the tunnel for contra-aperture drainageing and the forte or the shortage of it in the treatment of posterior horseshoe anal fistula of superior position.Methods:The 40 cases of posterior horseshoe anal fistula of superior position were randomly divided into trials group and controlled group,20 cases in trials group received the modus operandi with intercept the trail,tie the muscle and with a floating-rubber tissue in the tunnel for contra-aperture drainageing,20 cases in controlled group received the modus operandi with arc incisions sutured.To observe the curative effect、the operability of operative procedure、the afterreaction and complication of operative procedure、the status of wound healing and the anal disfunction and the relapse rate in six months.The relative results were calculated statistically with SPSS13.0 software.Statistical standard was accepted as the "α" value equal 0.05 for double tailed test.Results:The trials group surpass the controlled group in the aspects of the time of the operation、the volume of blood loss in operation and in the postoperative pain in the following three days after the first day of operation,The hydropsia of incisal opening(P＜0.05),The controlled group surpass the trials group in the aspects of the time of the healing(P＜0.05),There was no difference between the two groups in the postoperative pain in the first day,the retention of urine,the secondary infection,the anal disfunction,the curative effect and the relapse rate in six months(P＞0.05).And in the whole,scored with weighting,there was no difference between the two groups(P＞0.05).Conclusion:The modus operandi with intercept the trail,tie the muscle and with a floating-rubber tissue in the tunnel for contra-aperture drainageing could not only protect the anal function and give anal fistula a radical cure but also have evident technical dominance,such as the advangtage in manipuility,the smaller lesions in operation,and so on,Furthermore it effectively prevent the postoperative complications.In all,the modus operandi with intercept the trail,tie the muscle and with a floating-rubber tissue in the tunnel for contra-aperture drainageing should be a superordinary technique in in the treatment of posterior horseshoe anal fistula of superior position.更多还原