杨方武　马健　李祥龙　赵莉　刘涛

【摘要】 目的：探讨分析应用潜行刨削术和传统切开挂线疗法治疗复杂性肛瘘的临床效果。方法：选取笔者所在医院收治的83例复杂性肛瘘患者作为研究对象，并随机分为试验组（42例）和对照组（41例），对照组患者行传统切开挂线术，试验组患者行潜行刨削术，对两组患者的治疗效果和肛肠动力学指标进行检测。结果：术后，两组患者均在近期治愈；对照组患者肛门功能在术后相比术前降低，差异有统计学意义（P<0.05），试验组患者手术前后肛门功能比较差异无统计学意义（P>0.05）；试验组创面愈合时间、住院时间等均明显优于对照组（P<0.05），且试验组出现复发的情况少于对照组。结论：潜行刨削术相对于传统切开挂线术治疗复杂性肛瘘具有较好的手术效果，复发少，缩短了患者住院时间，对患者肛门括约肌功能以及肛门周围皮肤的损伤也较小。

【关键词】 复杂性肛瘘； 潜行刨削术； 切开挂线疗法

中图分类号 R574.8 文献标识码 A 文章编号 1674-6805（2016）5-0011-02

【Abstract】 Objective：To observe and discuss the clinical efficacy of thread-drawing and counter drainage operation and sneak planning operation in the treatment of high complex anal fistula.Method：83 cases with complex anal fistula were selected as research subjects，and they were randomly divided into the study group（42 cases） and the control group（41 cases），the study group were given sneak planning operation，while the control group were given thread-drawing and counter drainage operation.Finally the quality of post-operation and anorectal dynamics indicators of patients were compared and analyzed.Result：After the operation，the patients of two groups were cured recently.The results of testing of anal function showed that the difference between preoperation and postoperation in the study group was no significant（P>0.05）， while the significant difference between preoperation and postoperation in the control group was existed（P<0.05）.Compared with the control group，the study group were better in the time of wound concrescence，the time of in hospital（P<0.05），and the rate of relapse of the study group was lower.Conclusion：Sneak planning operation has more remarkable effect in the treatment of complex anal fistula than thread-drawing and counter drainage operation，it can decrease the relapse rate，the time in hospital and treating process，and can protect the function of anal sphincter and integrity of skin around anal.

【Key words】 Complex anal fistula； Sneak planning operation； Thread-drawing and counter drainage operation

First-authors address：The Central Hospital of Zaozhuang Mining Group，Zaozhuang 277800，China

doi：10.14033/j.cnki.cfmr.2016.5.005

復杂性肛瘘是医学界普遍公认的难题，在临床上的发病率也较高，存在许多并发症，由于在手术过程中既要考虑消除症状又要兼顾保护肛门括约肌功能，因此给治疗带来了许多困难[1]。传统切开挂线疗法虽然治愈效果明显，但是该手术治疗疗程长、对肛门括约肌功能损害大、患者需要承受的痛苦多，存在许多不足[2]。潜行刨削术治疗肛瘘方法是一种新的保括约肌技术[3]，笔者所在医院在2010年6月-2014年12月，对收治的42例复杂性肛瘘患者进行了潜行刨削术治疗，效果理想，现汇报如下。

1 资料与方法

1.1 一般资料

所有研究对象均来源于2010年6月-2014年12月笔者所在医院肛肠小儿外科诊治的复杂性肛瘘患者，诊断依据2012肛周脓肿和肛瘘诊治策略-解读美国和德国指南诊治指南[4]。经笔者所在医院道德伦理委员会批准，所有参与患者均签署知情同意书。以……