中国中西医结合外科杂志2025，Vol.31Issue(3)：340-345,6.DOI:10.3969/j.issn.1007-6948.2025.03.005
改良经肛括约肌间切开术联合消炎止痛方坐浴在高位复杂性肛瘘中的应用效果
Application of modified transanal opening of intersphincteric space combined with Xiaoyan Zhitong prescription sitz bath in high complex anal fistula
摘要
Abstract
Objective To explore the application of modified transanal opening of intersphincteric space(TROPIS)combined with Xiaoyan Zhitong prescription(external washing No.1 prescription)sitz bath in high complex anal fistula.Methods 110 patients with high complex anal fistula in our hospital were selected from January 2021 to December 2022,and the patients were randomized into sitting bath group(55 cases)and surgical group(55 cases)by random number table method.The surgical group was treated with modified TROPIS,while the sitting bath group was given modified TROPIS combined with Xiaoyan Zhitong prescription sitz bath.The clinical efficacy(wound healing time,cure rate and recurrence rate)was compared.The differences in TCM symptoms scores,anorectal dynamics and quality of life[Fecal Incontinence Quality of Life(FIQL)]were recorded before surgery and at 3 months after surgery.The adverse reactions(bleeding,infection,urinary retention,defecation disorder)during treatment were statistically analyzed.Results The wound healing time in sitting bath group with(13.62±1.46)d was shorter than(17.67±1.86)d in surgical group,the number of gauze soaked with secretions(16.80±2.15)was lower than that in the surgical group(29.63±2.48),and the pH value of secretions(8.40±0.68)was higher than that in the surgical group(6.56±0.99),and the recurrence rate was lower compared to surgical group(1.82％vs 14.55％)(P＜0.05).There was no significant difference in cure rate between the two groups(94.55％vs 90.91％)(P＞0.05).The RRP,MTV and RC were risen in both groups at 3 months after surgery,and the indicators with(2.07±0.47)kPa,(192.55±17.31)mL and(4.08±1.12)mL/mmHg in sitting bath group group were higher than(1.84±0.43)kPa,(168.94±15.77)mL and(3.27±1.02)mL/mmHg in surgical group.At 3 months after surgery,the ARP and scores of pruritus,swelling pain and pus,Wexner scores and FIQL scores in the two groups were declined compared with those before treatment,and the ARP and scores of pruritus,swelling and pain,and purulent discharge in sitting bath group with(7.18±1.04)kPa,(1.62±0.27)points,(1.41±0.25)points,(1.37±0.21)points,were lower than(79.42±1.13)kPa,(1.85±0.31)points,(1.59±0.22)points,(1.65±0.24)points in surgical group(P＜0.05).There were no significant differences in the incidence rates of adverse reactions between groups(P＞0.05).Conclusion Modified TROPIS combined with Xiaoyan Zhitong prescription(external washing No.1 prescription)sitz bath can effectively promote wound healing,and improve postoperative anal function and quality of life in patients with high complex anal fistula.关键词
高位复杂性肛瘘/改良经肛括约肌间切开术/消炎止痛方坐浴/肛门功能/创面愈合时间Key words
High complex anal fistula/modified transanal opening of intersphincteric space/external washing prescription sitz bath/anal function/wound healing time分类
医药卫生引用本文复制引用
张庆,朱勇,汪永洋..改良经肛括约肌间切开术联合消炎止痛方坐浴在高位复杂性肛瘘中的应用效果[J].中国中西医结合外科杂志,2025,31(3):340-345,6.基金项目
安庆市卫生健康委科研课题(AQWJ2022013) （AQWJ2022013）
