张杰

【摘要】 目的 比較同一种疾病通过一次切开根治术与切开引流手术，观察对比在肛管后间隙脓肿治疗效果，为肛管后间隙脓肿治疗提供理论依据。治疗方法：搜集病例2019年1 月至2019年12月在我科收治的肛周脓肿（肛管后间隙脓肿），排除高位、复杂性脓肿患者70例，年龄14-82岁，男性62例，女性8例，分为两组，观察组 （n=35）接受一次切开根除术，对照组（n=35）接受切开引流术，通过比较两组患者的住院时间，创面生长时间，术后疼痛、出血，复发率，得出结果：观察组患者痊愈率为 91.42 %，对照组为62.86 %，P<0.05;观察组患者的手术时间，创面愈合时间，住院时间均明显大于对照组，P<0.05;观察组患者术后疼痛、术中及术后出血发生率和脓肿复发率均明显低于对照组，P<0.05。结论：肛管后间隙脓肿一次切开根除术对于切开根治术，手术创面相对较大、术后恢复偏长，但可明显提高肛管后间隙脓肿的手术效果，手术并发症和复发率均明显降低，具有一定的指导意义。在临床工作中，我们对于早期肛周皮下脓肿，特别是低位脓肿，尽量做一次性切开根治术，可避免再次复发，减轻患者痛苦，避免二次手术[2]。

【关键词】肛管后间隙脓肿;一次切开根治术;切开引流术;

【Abstract 】Objective To compare the difference between one radical incision and drainage for the same disease，To observe and compare the therapeutic effect of posterior anal space abscess in order to provide theoretical basis for the treatment of posterior anal space abscess. Treatment methods： A total of 70 patients with perianal abscess （posterior anal space abscess） admitted to our department from January 2019 to December 2019 were collected， and 70 patients with high and complex abscess were excluded，The patients in the observation group （n=35） received one incision and eradication， and the control group （n=35） received incision and drainage，The length of hospital stay， time of wound growth， postoperative complications （pain， bleeding）， and recurrence rate were compared between the two groups. Results： The recovery rate was 91.25 % in the observation group and 63.34 % in the control group，P<0.05; The length of stay， wound healing time and length of stay in the observation group were significantly greater than those in the control group P<0.05;The incidence of postoperative complications （pain， bleeding） and abscess recurrence in the observation group were significantly lower than those in the control group，P<0.05。Conclusion： One incision for the resection of posterior anal space abscess is relatively large and postoperative recovery is longer， but it can significantly improve the surgical effect of posterior anal space abscess，One incision for the resection of posterior anal space abscess is relatively large and postoperative recovery is longer， but it can significantly improve the surgical effect of posterior anal space abscess， and significantly reduce the surgical complications and recurrence rate， which has certain guiding significance. In clinical work， for early perianal subcutaneous abscess， especially low abscess， we try to do one-time incision radical surgery， can avoid recurrence， relieve the pain of patients， avoid the second operation

【Keywords 】 Posterior anal space abscess;A radical incision;Incision and drainage

【中图分类号】R61   【文献标识码】A   【文章编号】2026-5328（2021）09--02

肛周脓肿，又称直肠肛管周围脓肿，在肛肠外科中属于常见病多发病，肛管周围软组织或周围间隙发生的急性化脓性疾病，常见原因为肛腺感染引起。根据位置不同，有肛周皮下脓肿，坐骨直肠窝脓肿，括约肌间脓肿，肛提肌上脓肿，直肠黏膜下脓肿，其中以肛管后间隙脓肿发病率最高，约占肛周脓肿45的%。……