侯辉

【摘要】 目的：探討切开挂线对口引流术治疗高位复杂性肛瘘的临床效果。方法：选取2017年4月-2018年4月笔者所在医院收治的高位复杂性肛瘘患者100例作为研究对象，采取随机数表法将患者分为两组，对照组实施常规切开挂线法治疗，观察组进行切开挂线对口引流术治疗，并对比患者术后的肛肠动力学测定结果，对两组患者的生活质量进行评分，使用SF-36量表进行比较。结果：术后观察组的临床总有效率为88.0%，高于对照组的66.0%，差异有统计学意义（P<0.05）。两组患者术前直肠静息压、肛管静息压、肛管最大收缩压等比较差异无统计学意义（P>0.05）;术后观察组患者直肠静息压、肛管静息压、肛管最大收缩压均明显高于对照组，差异均有统计学意义（P<0.05）。术后观察组的生活质量评分为（82.9±2.1）分，高于对照组的（60.3±6.2）分，差异有统计学意义（P<0.05）。结论：针对高位复杂性肛瘘患者进行切开挂线对口引流术治疗能够提高治疗效果。

【关键词】 切开挂线对口引流术 高位复杂性肛瘘 肛门括约肌 生活质量

doi：10.14033/j.cnki.cfmr.2019.28.055 文献标识码 B 文章编号 1674-6805（2019）28-0-03

Effect of Incision and Hang-line Drainage for the Treatment of High Complex Anal Fistula/HOU Hui. //Chinese and Foreign Medical Research， 2019， 17（28）： -134

[Abstract] Objective： To investigate the clinical efficacy of incision and hang-line drainage in the treatment of high complex anal fistula. Method： A total of 100 patients with high complex anal fistula admitted to the hospital from April 2017 to April 2018 were selected as subjects. The patients were divided into two groups by random number table method. The control group routine incision and thread-drawing therapy. The observation group was treated with incision and suture drainage. The results of postoperative anorectal kinetics were compared. The quality of life of the two groups was scored and compared using the SF-36 scale. Result： The total effective rate of the postoperative observation group was 88.0%， which was higher than 66.0% of the control group， the difference was statistically significant （P<0.05）. There were no significant differences in preoperative rectal resting pressure， canal resting pressure， maximum systolic pressure of the anal canal between the two groups （P>0.05）. The postoperative rectal rest pressure， anal canal resting pressure， maximum systolic blood pressure of the anal canal of the observation group were significantly higher than those of the control group， and the difference were statistically significant （P<0.05）. The quality of life score of the postoperative observation group was （82.9±2.1） points， which was higher than （60.3±6.2） points of the control group， the difference was statistically significant （P<0.05）. Conclusion： Incision and hang-line drainage for patients with high complex anal fistula can improve the treatment effect.

[Key words] Incision and hang-line drainage High complex anal fistula Anal sphincter Quality of life

First-authors address： Meizhou Peoples Hospital， Meizhou 514031， China

高位复杂性肛瘘的诊治一直都是肛肠外科的难题，国内外医学专家对于该病的诊治进行了多种研究和尝试，但是均不够成熟与规范[1-2]。目前来说，有效的治疗手段之一就是外科手术，保持肛门的形态与功能完整性仍然有待进一步的临床研究[3]。本研究探讨切开挂线对口引流术治疗复杂性肛瘘的临床效果，现将结果报告如下。

1 资料与方法

1.1 一般资料

选取2017年4月-2018年6月笔者所在医院收治的80例高位复杂性肛瘘患者，所有患者均符合全国肛肠学术会议制定的相关诊断标准，排除特异性感染造成的肛瘘;低位单纯性肛瘘;有肛门外伤史或肛门手术史患者;严重心肝肾肺功能障碍者;伴有恶性肿瘤者;有严重出血性疾病患者。……