毕宪坤

摘要：目的  探讨中药熏洗辅助分段挂线引流治疗高位肛周脓肿的临床疗效。方法  选取2016年2月～2018年8月我院收治的高位肛周脓肿患者123例，随机分为对照组（n=61）和观察组（n=62）。对照组予以常规分段挂线引流治疗，观察组予以中药熏洗辅助分段挂线引流治疗，比较两组临床疗效、创口愈合时间、术后并发症及复发情况。结果  观察组总有效率为98.39%，高于对照组的88.52%，差异有统计学意义（P<0.05）。观察组创面愈合时间为（14.02±2.12）d，短于对照组的（23.69±3.26）d，差异有统计学意义（P<0.05）。观察组术后创口渗液、肛瘘发生率及复发率分别为3.23%、1.61%、1.61%，均低于对照组的19.67%、11.48%、13.11%，差异有统计学意义（P<0.05）。结论  中药熏洗辅助分段挂线引流治疗高位肛周脓肿疗效显著，可促进创口愈合，降低术后并发症及复发风险，安全性较高。

关键词：高位肛周脓肿;中药熏洗;分段挂线引流

中图分类号：R657.1                                  文献标识码：A                                DOI：10.3969/j.issn.1006-1959.2019.15.051

文章編号：1006-1959（2019）15-0154-03

Abstract：Objective  To investigate the clinical efficacy of traditional Chinese medicine fumigation and washing combined with segmental drainage for the treatment of high perianal abscess.Methods  A total of 123 patients with high perianal abscess admitted to our hospital from February 2016 to August 2018 were randomly divided into control group （n=61） and observation group （n=62）. The control group was treated with routine segmental drainage and the observation group was treated with traditional Chinese medicine fumigation and washing. The clinical efficacy， wound healing time， postoperative complications and recurrence were compared between the two groups.Results  The total effective rate of the observation group was 98.39%， which was higher than that of the control group 88.52%，the difference was statistically significant （P<0.05）. The wound healing time of the observation group was（14.02±2.12）d， which was shorter than that of the control group（23.69±3.26）d，the difference was statistically significant （P<0.05）. The incidence of exudate and anal fistula， recurrence rate was  3.23%， 1.61%， 1.61% in the observation group， which were lower than those in the control group 19.67%、11.48%、13.11%， the difference was statistically significant（P<0.05）.Conclusion  Traditional Chinese medicine fumigation and washing assisted segmental drainage for the treatment of high perianal abscess is effective， which can promote wound healing， reduce the risk of postoperative complications and recurrence， and has higher safety.

Key words：High perianal abscess;Traditional Chinese medicine fumigation;Segmental hanging line drainage

肛周脓肿（perianal abscess）是发生于肛腺管入括约肌间隙的一种细菌感染性疾病，脓肿切开引流是治疗本病的主要手段，但术后脓肿极易复发，且术后肛瘘几率较高，需再次手术。分段挂线引流手术虽可在一定程度上降低术后肛瘘风险，降低二次手术率，但术后长时间肛周水肿及创口渗液等并发症严重影响愈合。近年来，中药熏洗疗法逐渐应用于肛周脓肿治疗，有研究认为[1]，中药熏洗坐浴将药物结合热效应，在促进血运同时达到消肿止痛、促进创面愈合目的。本文主要探讨中药熏洗辅助分段挂线引流治疗高位肛周脓肿的临床疗效，现报道如下。

1资料与方法

1.1一般资料  选取2016年2月～2018年8月佳木斯市中医院收治的高位肛周脓肿患者123例，按照随机数字表法分为对照组和观察组。对照组61例，其中男39例，女22例;年龄22～62岁，平均年龄（38.26±6.02）岁;病程6～19 d，平均病程（9.12±2.48）d;疾病类型：坐骨直肠间隙脓肿28例，骨盆直肠间隙脓肿21例，直肠后间隙脓肿12例。……