三间隙引流术治疗肛周脓肿的临床疗效及对患者肛门功能的影响OA
Clinical efficacy of three-space drainage surgery in treating perianal abscess and its impact on anorectal function
目的 探讨三间隙引流术治疗肛周脓肿(PA)的临床疗效及对患者肛门功能的影响,以期为优化PA的临床治疗策略提供参考.方法 回顾性分析2021年1月-2024年1月在成都市中西医结合医院治疗的202例PA患者的临床资料,依据手术方式的差异分为对照组和观察组,每组101例.对照组患者采用传统切开挂线术治疗,观察组患者采用三间隙引流术治疗,比较2组患者的临床疗效、围手术期相关指标、疼痛程度、肛门功能变化及并发症发生情况.结果 对照组和观察患者治疗总有效率分别为95.05％(96/101)和98.02％(99/101),差异无统计学意义(x2=0.592,P=0.442).观察组患者术中出血量少于对照组,住院时间及首次排便时间均短于对照组,差异均有统计学意义(P＜0.05).2组患者术后1 d的视觉模拟评分法(VAS)评分比较,差异无统计学意义(P＞0.05);观察组患者术后7 d及30 d的VAS评分均低于对照组,差异均有统计学意义(P＜0.05).观察组患者术后1 d的Wexner评分低于对照组,差异有统计学意义(P＜0.05);2组患者术后7 d及30 d的Wexner评分比较,差异均无统计学意义(P＞0.05).观察组患者术后并发症发生率为3.96％(4/101),低于对照组的11.88％(12/101),差异有统计学意义(x2=4.344,P=0.037).结论 三间隙引流术与传统切开挂线术治疗PA的临床疗效相当,但在减轻术后疼痛、保护肛门功能及降低术后并发症发生风险方面具有明显优势,值得临床推广应用.
Objective To explore the clinical efficacy of three-space drainage surgery in the treatment of perianal abscess(PA)and its impact on anorectal function,aiming to provide a reference for optimizing clinical treatment strategies for PA.Methods A retrospective analysis was conducted on the clinical data of 202 PA patients treated at Chengdu Integrated TCM &Western Medicine Hospital from January 2021 to January 2024.According to the differences in surgical methods,the pa-tients were assigned to a control group and an observation group,with 101 cases in each group.The control group received conventional incision and drainage;while the observation group,three-space drainage surgery.Clinical efficacy,periopera-tive indicators,pain levels,changes in anorectal function,and the occurrence of complications were compared between the two groups.Results The overall therapeutic response rate was 95.05％(96/101)in the control group and 98.02％(99/101)in the observation group,with no statistically significant difference(x2=0.592,P=0.442).The observation group had significantly less intraoperative blood loss,shorter hospital stays,and earlier time to first defecation compared to the control group(P＜0.05).On postoperative day 1,the visual analog scale(VAS)scores for pain were not significantly dif-ferent between the groups(P＞0.05);however,the VAS scores on postoperative days 7 and 30 were significantly lower in the observation group than in the control group(P＜0.05).On postoperative day 1,the Wexner score for anorectal function in the observation group was significantly lower than that in the control group(P＜0.05);there were no significant differ-ences between the two groups in the Wexner score on postoperative days 7 and 30(P＞0.05).The complication rate in the observation group was significantly lower than that in the control group(3.96％[4/101]vs.11.88％[12/101];x2=4.344,P=0.037).Conclusion The clinical efficacy of three-space drainage surgery for treating PA is comparable to con-ventional incision and drainage,but it has distinct advantages in reducing postoperative pain,protecting anorectal function,and lowering the risk of postoperative complications,justifying its clinical promotion.
蒋建荣;刘盛;魏长成;曾林;王秀敏;陈晓辉;谢彦鹏
四川省成都市中西医结合医院/四川省成都市第一人民医院/成都中医药大学附属中西医结合医院肛肠科,成都 610041四川省江油市第四人民医院普外科,四川江油 621702四川省江油市第四人民医院普外科,四川江油 621702四川省江油市第四人民医院普外科,四川江油 621702四川省成都市中西医结合医院/四川省成都市第一人民医院/成都中医药大学附属中西医结合医院肛肠科,成都 610041四川省成都市中西医结合医院/四川省成都市第一人民医院/成都中医药大学附属中西医结合医院肛肠科,成都 610041四川省成都市中西医结合医院/四川省成都市第一人民医院/成都中医药大学附属中西医结合医院肛肠科,成都 610041
医药卫生
肛周脓肿三间隙引流术传统切开挂线术临床疗效肛门功能肛周疼痛
Perianal abscessThree-space drainage surgeryConventional incision and drainageClinical efficacyAnorectal functionPerianal pain
《保健医学研究与实践》 2025 (6)
45-50,6
四川省中医药科学技术研究专项课题(2024MS589).
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