内口切闭联合瘘道潜行刨削术治疗肛瘘的临床研究

发布时间：2018-02-13 17:15

本文关键词： 肛瘘闭合内口潜行刨削切闭器　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：对内口切闭联合瘘道潜行刨削术治疗肛瘘的临床疗效性及安全性进行评价。方法:选取2015年1月-2016年1月由南京市中医院王业皇教授进行手术治疗的70例肛瘘患者,依自愿原则分两组,试验组(n=32)采用内口切闭联合瘘道潜行刨削术治疗,对照组(n=38)采用传统切开术或切开挂线术治疗。比较两组疼痛程度、肛门括约肌功能及不良事件发生率,并随访3个月,记录愈合时间和治疗结果。观察结果根据评分标准均作量化记录,经统计学处理,分析其疗效性、微创性、安全性等方面的差异。结果：(1)试验组和对照组的总有效率分别为96.87%和92.10%,差异无统计学意义(P--0.668)。(2)两组的术后VAS疼痛评分比较,术后第1天、第3天差异均无统计学意义(P0.05)；术后第7天、第15天、第30天、第50天差异有统计学意义(P0.05)。(3)两组的术前Wexner评分比较,无统计学差异(P0.05),具有可比性；两组术后第1月、第2月、第3月的Wexner评分比较,有统计学差异(P0.05)；试验组的Wexner评分在术前和术后第3月比较,无统计学差异(P0.05),对照组反之。(4)两组的术前肛门功能指诊评分比较,无统计学差异(P0.05),具有可比性；两组术后第1月、第2月的肛门功能指诊评分比较,无统计学差异(P0.05),两组术后第3月的肛门功能指诊评分比较,有统计学差异(P0.05)；试验组的肛门功能指诊评分在术前和术后第3月比较,无统计学差异(P0.05),对照组反之。(5)两组在创面愈合时间上的差异有统计学意义(P0.05)。(6)两组的安全性结果比较,差异无统计学意义(P0.05)。(7)痊愈后随访3个月,试验组复发0例,对照组复发1例(2.63%),差异无统计学意义(P0.05)。结论：采用内口切闭联合瘘道潜行刨削术治疗肛瘘是一种安全的微创术式,其疗效确切,可减轻痛苦、减小肛门损伤、缩短愈合时间。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of internal incision combined with closed fistula in the treatment of anal fistula. Methods: from January 2015 to January 2016, 70 cases of anal fistula treated by Professor Wang Yehuang, Nanjing traditional Chinese Medicine Hospital, were selected. According to the voluntary principle, the experimental group was divided into two groups. The experimental group was treated with internal incision and closed fistula, and the control group was treated with traditional incision or incision and thread. The degree of pain, anal sphincter function and the incidence of adverse events were compared between the two groups. The healing time and treatment results were recorded for 3 months. The results were quantitatively recorded according to the scoring criteria, and the curative effect and minimally invasive effect were analyzed by statistical analysis. Results the total effective rates of the two groups were 96.87% and 92.10, respectively. There was no significant difference in postoperative VAS pain score between the two groups. There was no significant difference in preoperative Wexner scores between the two groups on the 3rd day (P 0.05); on the 7th, 15th, 30th and 50th day after operation, there was no significant difference in preoperative Wexner scores between the two groups (P 0.05); on January, February, there was no significant difference between the two groups. In March, there was a significant difference in Wexner scores between the two groups (P 0.05). There was no significant difference in the Wexner scores between the two groups before and after operation (P 0.05), whereas in the control group (P 0. 05), there was no significant difference between the two groups before and after operation (P 0. 05). There was no statistical difference between the two groups (P 0.05), there was no statistical difference between the two groups in anal functional finger-diagnosis scores on January and February, and there was no significant difference between the two groups in anal function index scores on March. There was no significant difference in anal function index score between the two groups before and after operation on March, but there was no significant difference in the wound healing time between the two groups (P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05). There was no significant difference between the two groups in 3 months after recovery. There were 0 cases of recurrence in the trial group and 1 case in the control group. The difference was not statistically significant (P 0.05). Conclusion: it is a safe and minimally invasive procedure to treat anal fistula with closed internal orostomy combined with latent planning of fistula. Its curative effect is accurate, can alleviate pain, reduce anal injury, shorten healing time.
【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】：2016
【分类号】：R266

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