超声引导下高位肛门脓肿隧道拖线引流术的临床研究*

上海市长宁区天山中医医院肛肠科

吴彬丁敏△徐伟△△应光耀△△△(上海 200051)

提要目的：通过多中心、随机、对照方法，研究超声引导下高位肛门脓肿隧道拖线引流术的临床疗效。方法：120例高位肛门脓肿患者，随机分为治疗组和对照组，治疗组采用超声引导下高位肛门脓肿隧道拖线引流术，对照组采用常规隧道拖线引流术。对两组的治愈率、术后疼痛评分、尿潴留、出血发生率、肛门形态、肛门功能、复发率、术后不良反应、满意度、住院时间、住院费用等指标进行比较。结果：两组在治愈率、术后出血、肛门形态、肛门功能、术后不良反应、病人满意度方面差异无显著性；治疗组复发率显著低于对照组；治疗组在降低术后疼痛、尿潴留方面优于对照组；治疗组在住院时间及费用的经济学指标方面，明显优于对照组。结论：超声引导下高位肛门脓肿隧道拖线引流术可以减少术后疼痛、尿潴留的发生率，降低术后复发率，缩短病程，降低住院费用。是临床治疗高位肛门脓肿的有效、安全、微创的新方法。

关键词超声引导；高位肛门脓肿；隧道拖线引流术；急性感染；脏毒；悬痈

中图分类号：R266

文献标识码：码：A

文章编号：号：1007-5615(2015)03-0010-06

AbstractObjective: to study the curative effect of drainage of tunnel with high anal abscess by ultrasound guidance through multicenter, random and contrast methods. Methods: 120 cases with high anal abscess were randomly divided into treatment group and control group, the former treated with the drainage of tunnel with high anal abscess by ultrasound guidance while the latter with the common drainage of tunnel. Compare their recovery rate, postoperative pain score, urinary retention, bleeding incidence, anal form, anal function, recurrence rate, postoperative adverse reaction, degree of satisfaction, length of stay, cost of hospitalization, etc. Results: There was no significant difference between the indexes such as recovery rate, postoperative bleeding, anal form, anal function, postoperative adverse reaction and degree of satisfaction; the recurrence rate of treatment group was significantly lower than that of control group; treatment group is superior to control group in decreasing postoperative pain and urinary retention, and also in length of stay and cost of hospitalization. Conclusion: drainage of tunnel with high anal abscess by ultrasound guidance can decrease postoperative pain, and urinary retention, lower the recurrence rate, shorten the course of disease, and reduce the cost of hospitalization, which is a new safe, effective and minimally invasive method in treating high anal abscess.

Clinical Study on Drainage of Tunnel with High Anal Abscess

by Ultrasound Guidance

Anus-intestines Department of Tianshan TCM Hospital, Changning District Shanghai

WUBinDINGMinXUWeiYINGGuang-yao(Shanghai 200051)

Key words ultrasound guidance; high anal abscess; drainage of tunnel; acute infection; anal ulcer; perianal abscesses

肛门脓肿系肛管直肠周围软组织间隙急性感染所形成的化脓性病变，其中高位肛门脓肿占病例总数20%~40%，属于国内外公认的肛肠疑难急症。中医学有“脏毒”“悬痈”“坐马痈”“跨马痈”等名称。最早于《黄帝内经》中就有论述：“痈疽发于尻，名曰锐疽，其状赤坚大，急治之，不治三十日死矣。……