郑镇波 郑伟雄 周雁苹

【摘要】 目的：探討高位肛瘘采用虚实结合挂线法与实挂线法治疗对患者肛门功能及创面愈合改善情况的效果。方法：按照掷硬币方式将笔者所在医院2017年1月-2019年8月收治的68例高位肛瘘患者分为对照组（n=34）和观察组（n=34）。对照组予以实挂线法治疗，观察组采取虚实结合挂线法治疗。观察两组治疗后总有效率、术后不同时间点VAS评分及术后恢复情况。结果：观察组治疗总有效率（97.06%）较对照组（79.41%）高（P<0.05）;观察组术后24 h、术后3 d及术后7 d的VAS评分分别比对照组同时间点低（P<0.05）;观察组创面愈合时间较对照组早（P<0.05），肛门功能评分较对照组低（P<0.05）。结论：对高位肛瘘采用虚实结合挂线法治疗可提高治疗总有效率，降低术后疼痛感，加快创面愈合及促进肛门功能恢复。

【关键词】 高位肛瘘 虚实结合挂线法 VAS评分 肛门功能

doi：10.14033/j.cnki.cfmr.2020.17.065 文献标识码 B 文章编号 1674-6805（2020）17-0-03

Comparison of Clinical Effect of Treating High Anal Fistula by the Combination of Deficiency and Excess with the Thread-hanging Method and Actual Thread-hanging /ZHENG Zhenbo， ZHENG Weixiong， ZHOU Yanping. //Chinese and Foreign Medical Research， 2020， 18（17）： -154

[Abstract] Objective： To investigate the effect of treating high anal fistula with the method of combining deficiency and excess with thread-hanging and actual thread-hanging on the improvement of anal function and wound healing. Method： From January 2017 to August 2019， 68 patients with high anal fistula treated in our hospital were divided into the control group （n=34） and the observation group （n=34） according to coin flipping method. The control group was treated with actual thread-hanging ， while the observation group was treated with the combination of deficiency and excess with thread-hanging and actual thread-hanging . The total effective rate after treatment， VAS score at different time points after operation and postoperative recovery were observed in both groups. Result： The total effective rate of patients in the observation group （97.06%） was higher than that in the control group （79.41%）， there was significant difference （P<0.05）. VAS scores of patients in the observation group at 24 h， 3 d and 7 d after operation were lower than those in the control group at 24 h， 3 d and 7 d after operation， respectively （P<0.05）. Wound healing time of patients in the observation group was earlier than that in the control group （P<0.05）， and the energy score was lower than that of the control group （P<0.05）. Conclusion： The treatment of high anal fistula by the combination of deficiency and excess with thread-hanging can improve the total effective rate of treatment， reduce postoperative pain， accelerate wound healing and promote the recovery of anal function.

[Key words] High anal fistula Combination of deficiency and excess with actual thread-hanging VAS score Anal function

First-authors address： Changan Hospital， Dongguan City， Dongguan 523841， China

高位肛瘺是肛肠外科治疗难度较大的疾病，目前主要采取手术治疗。其目的在于清除原发病灶尽量保护肛门的正常的解剖结构和维持其生理功能。传统的实挂线法虽取得一定的治疗效果，但易导致肛门周围大量肌肉损伤，使创面愈合时间增加且影响肛门功能的恢复。虚实结合挂线法是在传统的实挂线法的基础上采用丝线虚挂引流，术中不损害肛直环的解剖形态。故为进一步探讨虚实结合挂线法治疗高位肛瘘患者的临床效果及对肛门功能的影响，本研究对笔者所在医院2017年1月-2019年8月收治的68例高位肛瘘患者分别采用实挂线法和虚实结合挂线法治疗，结果如下。

1 资料与方法

1.1 一般资料

研究对象选取笔者所在医院收治且进行手术治疗的高位肛瘘患者68例，本研究经患者同意，且医院伦理委员会已批准。纳入标准：年龄20～55岁，单纯性高位肛瘘;排除标准：合并严重肝肾疾病、凝血功能障碍且存在手术禁忌证。……