程丽斌 柯邱红 赵林华 黄永兵

【摘要】 目的：研究肛周脓肿切开排脓术加仙方活命饮加减治疗婴幼儿肛周脓肿的效果。方法：选择笔者所在医院2015年3月-2018年3月接诊的肛周脓肿患儿86例作为研究对象，将其随机分为治疗组和对照组，每组43例。两组患儿均行肛周脓肿切开引流术，对照组术后给予高锰酸钾片便后温水稀释坐浴;治疗组术后给予仙方活命饮加减温药汤便后坐浴。比较两组临床疗效、切口愈合时间及复发率。结果：治疗组总有效率明显高于对照组，差异有统计学意义（P<0.05）。治疗组切口愈合时间短于对照组，差异有统计学意义（P<0.05）。两组均随访1年，对照组复发率高于治疗组，差异有统计学意义（P<0.05）。结论：肛周脓肿切开排脓术加仙方活命饮加减治疗婴幼儿肛周脓肿效果显著，可有效促进切口愈合，降低复发率。

【关键词】 肛周脓肿 切开排脓 婴幼儿 疗效 仙方活命饮加减

doi：10.14033/j.cnki.cfmr.2020.24.051 文献标识码 B 文章编号 1674-6805（2020）24-0-03

[Abstract] Objective： To study the effect of perianal abscess incision and drainage and modified Xianfang Huomingyin Decoction on perianal abscess in infants. Method： A total of 86 infants with perianal abscess treated in our hospital from March 2015 to March 2018 were selected as the study subjects， and were randomly divided into the treatment group and the control group， with 43 cases in each group. Perianal abscess incision and drainage were performed in both groups. After operation， the control group was given Potassium Permanganate Tablets and then diluted with warm water for sitz bath. After operation， the treatment group was given modified Xianfang Huomingyin Decoction warm medicine decoction for sitz bath. The clinical efficacy， incision healing time and recurrence rate of the two groups were compared. Result： The total effective rate of the treatment group was significantly higher than that of the control group， the difference was statistically significant （P<0.05）. The incision healing time in the treatment group was shorter than that in the control group， and the difference was statistically significant （P<0.05）. Both groups were followed up for 1 year， the recurrence rate in the control group was higher than that in the treatment group， and the difference was statistically significant （P<0.05）. Conclusion： Perianal abscess incision and drainage and modified Xianfang Huomingyin Decoction in the treatment of infant perianal abscess have remarkable effect， which can effectively promote the incision healing and reduce the recurrence rate.

[Key words] Perianal abscess Incision and drainage Infants Curative effect Modified Xianfang Huoming Decoction

First-authors address： The First Hospital of Putian City， Putian 351100， China

肛周膿肿是由肛腺感染化脓蔓延到肛管直肠周围间隙形成的脓肿[1]。《素问·生气通天论篇》中说：“营气不从，逆于肉理，乃生痈肿”[2]。故中医称为“肛痈”。其发病率在肛门直肠疾病中占25%，多见于20～40岁的青壮年，男性多于女性，婴幼儿也时有发生[1]。婴幼儿肛周脓肿多发生在3岁以下幼儿，新生儿及3个月以内婴儿多见。但由于婴幼儿肛门括约肌薄弱，损伤太大容易造成肛门功能的异常，如肛门变形、肛门缺损等，严重者甚至导致肛门失禁，且由于婴幼儿年龄小，术中及术后换药依从性差，故多采取切开排脓的方法。笔者运用肛周脓肿切开排脓术加仙方活命饮加减治疗婴幼儿肛周脓肿，重点剖析中西医结合疗法在婴幼儿肛周脓肿中的应用价值，现报道如下。

1 资料与方法

1.1 一般资料

选择笔者所在医院2015年3月-2018年3月接诊的肛周脓肿患儿86例作为研究对象，纳入标准：（1）符合肛周脓肿诊断标准;（2）患者依从性较好且未中断治疗。……