采用虚挂线疗法治疗高位肛周脓肿及高位肛瘘回顾性分析

发布时间：2018-02-02 23:27

本文关键词： 虚挂线疗法实挂线高位肛周脓肿高位肛瘘　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:回顾性分析十一五期间采用虚挂线疗法治疗高位肛周脓肿及高位肛瘘住院患者,分析包括治愈率、复发率、肛门功能评分的情况;明确虚挂线疗法的远期疗效,探讨虚挂线引流法治疗高位肛周脓肿及高位肛瘘科学性、有效性及安全性;同时也为十二五国家支撑项目课题的顺利开展作下铺垫。方法:回顾性分析十一五期间(2007.12-2010.12)诊断为高位肛瘘及高位脓肿手术住院患者,共193例。其中高位肛瘘114例(采用虚挂线56例,实挂线58例);高位肛周脓肿79例(采用虚挂线42例,实挂线37例)。通过查阅病例,电话回访、邮件及信访,观察术后治愈情况、肛门功能评分、复发情况。结果:本次回访过程中共收集有效调查表95份;经调查,两组患者术后创面均完全愈和;经统计分析,通过总疗效对比,虚挂线组中分别在术后第3、4年,各有1例患者复发,第6年有2例患者再发肛周脓肿;实挂线组中分别在术后第2、3年,各有2例复发,第5、6、7年各有1例患者再发。虚挂线组复发率为3.92%,实挂线组复发率为4.54%;通过对两组回访者的肛门功能进行评价分析,两组差异有统计学意义(P＜0.05)。结论:经统计学分析,两组患者在肛门功能评价,差异均有统计学差异(P0.05),虚挂线组能更好保护肛门括约肌的功能,避免肛门失禁、畸形等并发症的发生。虚挂线法符合现代微创外科学理论,其注重对肛门括约肌的保护,更加强调其引流及异物刺激作用,通过回顾性对比分析,虚挂线法运用于治疗高位脓肿及高位肛瘘是有效及安全的,值得临床上推广运用。
[Abstract]:Objective: to retrospectively analyze the inpatients with high perianal abscess and high anal fistula treated with deficiency and thread therapy during the 11th Five-Year Plan period, analyze the cure rate, recurrence rate and anal function score, and clarify the long-term curative effect of the therapy. To explore the scientific, effective and safe treatment of high perianal abscess and high anal fistula. At the same time, it also paved the way for the smooth development of the National support Project of the Twelfth Five-Year Plan. Methods: the inpatients with high anal fistula and high abscess were diagnosed as high anal fistula and high abscess by retrospective analysis during the 11th Five-Year Plan period (2007.12-2010.12). There were 193 cases of high anal fistula, including 114 cases of high anal fistula (56 cases with virtual thread, 58 cases with solid thread, 79 cases with high perianal abscess (42 cases with virtual thread and 37 cases with solid thread). Results: a total of 95 effective questionnaires were collected in the course of this visit. After investigation, the wounds of the two groups were completely recovered. After statistical analysis, the total curative effect was compared. In the vacuity thread group, 1 patient recurred in the 3th and 4th year after operation, 2 patients re-developed perianal abscess in the sixth year, and 2 patients recurred each in the 2nd and 3rd year after the operation. In the 6th and 7th year, there was a recurrence rate of 1 patient in each group. The recurrence rate was 3.92 in the virtual thread group and 4.54 in the real thread group, the anal function of the two groups was evaluated and analyzed, and the difference between the two groups was statistically significant (P < 0.05). Conclusion: by statistical analysis, the recrudescence rate of the two groups is significantly higher than that of the control group (P < 0.05), and the difference between the two groups is significant (P < 0.05). There were significant differences in anal function evaluation between the two groups (P 0.05). The virtual thread group could better protect the anal sphincter function and avoid the complications such as anal incontinence and malformation. It pays attention to the protection of anal sphincter, and emphasizes the effect of drainage and foreign body stimulation. Through retrospective comparison and analysis, it is effective and safe to treat high abscess and high anal fistula by the method of virtual thread, which is worth popularizing in clinic.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.1

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