摘要
Abstract
Objective:To analyze the clinical value of the treatment of anal fistula(AF)through intersphincter approach(hereinafter referred to as release)and incision drainage.Method:Clinical data of 126 patients with anal fistula admitted to Xiamen Changgeng Hospital from November 2022 to December 2023 was selected and retrospectively analyzed.They were divided into the control group and the observation group according to the differences in surgical methods.The control group(n=63 cases)received incision and drainage,and the observation group(n=63 cases)received loose drainage.The surgical and prognostic indexes,complications,Visual Analogue Scale(VAS)scores at different time points,anal function before and 3 months after surgery,and serum inflammatory factor levels before and 1 day after surgery were compared between the two groups.Result:Compared with the control group,the operation,postoperative hematochezia,wound healing,pus shedding and hospital stay in the observation group were shorter,and the difference was statistically significant(P<0.05).The results of repeated measurement variance Mauchly's sphericity test showed that the VAS scores of the two groups at different time points were consistent with the sphericity test,and the results did not need to be corrected by Greenhouse-Geisser method.According to the main effect analysis of measurement time,VAS scores of the two groups increased first and then decreased 1 h,1 d and 7 d after surgery,with statistical significance(P<0.05).The main effect analysis of the groups showed that the VAS scores of the observation group were lower than those of the control group 1 d and 7 d after surgery,and the difference was statistically significant(P<0.05).Compared with the control group,the serum levels of Interleukin-6(IL-6),Tumor Necrosis Factor-α(TNF-α),Interleukin-8(IL-8)and Wexner incontinence score in the observation group were lower 1 day after surgery,and the mean anal venous pressure and mean maximum anal constriction pressure were higher 3 months after surgery,with statistical significance(P<0.05).The complication rate of observation group(3.7%)was lower than that of control group(17.46%),and the difference was statistically significant(P<0.05).Conclusion:The treatment of AF can effectively shorten the operation time,reduce pain,reduce inflammatory stress,promote postoperative recovery,improve the anal function of patients with few complications.关键词
切割挂线引流术/括约肌/松弛挂线术/肛瘘/肛门功能Key words
Cutting and hanging drainage/Sphincter/Slack hanging technique/Anal fistula/Anal function
