吴文宗 廖星明

【摘要】 目的：探讨多切口加双套管负压引流技术在骨盆直肠间隙脓肿术后应用的临床效果。方法：选取笔者所在医院2015年3月-2019年3月收治的87例骨盆直肠间隙脓肿手术患者为研究对象，采用双套管负压引流的45例患者为观察组，采用常规乳胶管引流的42例患者为对照组。两组均行切开排脓术治疗，观察患者术后肛门功能恢复情况、康复速度、并发症发生率及满意度。结果：术后14 d，观察组VAS评分（1.01±0.02）分，Wexner评分（2.14±0.03）分，肉芽生长（4.36±0.13）级，切口愈合时间（23.15±2.30）d，引流时间（7.21±0.15）d，住院时间（14.11±0.51）d，感染率2.22%，延期愈合率2.22%，满意度97.78%，均明显优于对照组，差异有统计学意义（P<0.05）。结论：多切口加双套管负压引流技术应用于骨盆直肠间隙脓肿术后，可有效减轻疼痛，预防肛门失禁，促进肉芽生长，缩短引流时间和住院时间，促进切口愈合，降低并发症发生率，提高患者满意度，值得临床推广。

【关键词】 双套管负压引流术 骨盆直肠间隙脓肿 乳胶管引流

doi：10.14033/j.cnki.cfmr.2019.29.011 文献标识码 B 文章编号 1674-6805（2019）29-00-03

[Abstract] Objective： To investigate the clinical effect of multiple incision plus double cannula negative pressure drainage on pelvic rectal space abscess after operation. Method： A total of 87 patients with pelvic and rectal space abscess who were admitted in our hospital from March 2015 to March 2019 were selected as the study subjects. 45 patients who received double-cannula negative pressure drainage were selected as the observation group， and 42 patients who received conventional latex tube drainage were selected as the control group. The two groups were treated with incision and purulent operation. The recovery of anal function， recovery rate， complication rate and satisfaction were observed. Result： The VAS score （1.01±0.02） points， Wexner score （2.14±0.03） points， granulation growth （4.36±0.13） grade， incision healing time （23.15±2.30） d， drainage time （7.21±0.15） d， hospital stay （14.11±0.51） d， infection rate 2.22%， delayed healing rate 2.22% and satisfaction rate 97.78% in the observation group were significantly better than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Multiple incision plus double cannula negative pressure drainage applied to pelvic rectal space abscess surgery， can effectively relieve pain， prevent anal incontinence， promote granulation growth， shorten the drainage time and hospital stay，promote incision healing， reduce the incidence of complications， improve patient satisfaction， worthy of clinical promotion.

[Key words] Double cannula negative pressure drainage Pelvic rectal space abscess Latex tube drainage

First-authors address： The Second Hospital of Sanming， Yongan 366000， China

骨盆直肠间隙脓肿为肛肠科临床常见急症，需要急诊手术治疗。术后给予冲洗引流換药，是促进切口愈合、预防感染等并发症的主要途径。骨盆直肠间隙脓肿传统手术切开后，多以乳胶管引流为主的治疗方法，虽可取得一定的效果，但临床研究显示，术后患者存在肛门损伤较大、切口疼痛难忍、创面延迟愈合、肛门功能影响和肛瘘复发率高等缺点[1]。为改善患者的疗效及预后，笔者所在医院采用多切口加双套管负压引流技术应用于骨盆直肠间隙脓肿术后，取得了较好的效果。现于笔者所在医院2015年3月-2019年3月收治的87例骨盆直肠间隙脓肿手术患者为研究对象，采用双套管负压引流的45例患者作为观察组，采用常规乳胶管引流的42例患者作为对照组，阐述多切口加双套管负压引流的应用方法，观察其临床应用效果，现报道如下。……