临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (2): 88-.

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经括约肌间切开虚挂线术治疗高位复杂性肛瘘的疗效分析

  

  1. 玉林市容县中西医结合骨科医院 胃肠肛门外科,广西 玉林 537500
  • 出版日期:2025-04-01 发布日期:2025-08-11

Analysis of the therapeutic effect of intersphincteric incision and thread hanging surgery for high complex anal fistula

  1. Gastrointestinal and Anal Surgery Department of Rongxian Integrated Traditional Chinese and Western Medicine Orthopedic Hospital in Yulin City, Guangxi Yulin 537500, China
  • Online:2025-04-01 Published:2025-08-11

摘要:

目的 观察高位复杂性肛瘘应用经括约肌间切开虚挂线术治疗的临床效果。方法 选取玉林市容县中西医结合骨科医院 2021 年 6 月至 2024 年 6 月收治的高位复杂性肛瘘患者 90 例,按随机数字表法分为观察组 45 例和对照组 45 例,观察组采用经括约肌间切开虚挂线术治疗,对照组则采用常规切割挂线术治疗,比较两组患者术后肛门疼痛、创面愈合时间、疗效等指标。结果 观察组患者的临床疗效高于对照组(100.0% 比 91.1%),差异有显著性(P < 0.01)。观察组患者的创面愈合时间及住院时间均短于对照组,差异均有显著性(P < 0.001)。术前,两组患者的失禁评分无显著差异(P > 0.05);术后 3 个月及术后 6 个月,观察组患者的失禁评分低于对照组,差异均有显著性(P < 0.05)。术后 1d、2d,观察组患者的视觉模拟评分法(visual analogue scale,VAS)评分低于对照组,差异均有显著性(P < 0.01),但两组术后7d、10d VAS 评分无显著差异(P > 0.05)。观察组患者术后并发症发生率为 2.2%,无患者复发,其并发症发生率及复发率均低于对照组,差异均有显著性(P < 0.01)。结论 经括约肌间切开虚挂线手术方案可以缩短患者住院周期,减轻疼痛感,而且短期和长期的疗效均符合良好预期。

关键词: 高位复杂性肛瘘, 经括约肌间切开虚挂线术, 切割挂线术

Abstract:

Objective To observe the clinical effect of the application of intersphincteric incision and thread drawing surgery for the treatment of high complex anal fistula. Method A total of 90 patients with high complexity anal fistula admitted to Rongxian Integrated Traditional Chinese and Western Medicine Orthopedic Hospital in Yulin City from June 2021 to June 2024 were selected and randomly divided into an observation group of 45 cases and a control group of 45 cases using a random number table. The observation group was treated with intersphincteric incision virtual suture technique, while the control group was treated with conventional incision suture technique. The postoperative anal pain, wound healing time, and efficacy were compared between the two groups of patients. Result The clinical efficacy of the observation group was higher than that of the control group

(100.0% vs. 91.1%), and the difference was significant (P < 0.01). The wound healing time and hospitalization time of the observation group were significantly shorter than those of the control group (P < 0.001). Before surgery, there was no significant difference in incontinence scores between the two groups of patients compared to the control group (P > 0.05); At 3 and 6 months after surgery, the incontinence scores of the observation group were significantly lower than those of the control group (P < 0.05). On postoperative day 1 and 2, the visual analogue scale(VAS) scores of the observation group were significantly lower than those of the control group (P < 0.01), but there was no significant difference in VAS scores between the two groups on postoperative day 7 and 10 (P > 0.05). The incidence of postoperative complications in the observation group was 2.2%, with no patient recurrence. The incidence of complications and recurrence in the observation group were lower than those in the control group, and the differences were significant (P < 0.01). Conclusion The surgical plan of intersphincteric incision with virtual hanging line can reduce the hospitalization period of patients, alleviate their pain, and achieve good short-term and long-term therapeutic effects.

Key words: High-position complex anal fistula, Intersphincteric incision and false seton operation, Cutting seton operation