Clinical observation on intersphincter drainage in treatment of perianal abscess

ZHU Yuzhang; LI Peng; LI Xiaojia; HU Jie; JIN Wenqi; GUO Xiutian

doi:10.16306/j.1008-861x.2022.06.007

您当前的位置：

首页 >

文章列表页 >

Clinical observation on intersphincter drainage in treatment of perianal abscess

Clinical Research | 更新时间：2022-11-26

- Clinical observation on intersphincter drainage in treatment of perianal abscess
- Academic Journal of Shanghai University of Traditional Chinese Medicine Vol. 36, Issue 6, Pages: 39-45(2022)
- 作者机构：
  
  1.上海市浦东新区光明中医医院（上海　201399）
  2.上海中医药大学附属市中医医院（上海　200071）
- 作者简介：
- 基金信息：
- DOI：10.16306/j.1008-861x.2022.06.007
  CLC：
扫描看全文
朱煜璋,李鹏,李小嘉等.括约肌间引流术治疗肛周脓肿的临床观察[J].上海中医药大学学报,2022,36(06):39-45.

ZHU Yuzhang,LI Peng,LI Xiaojia,et al.Clinical observation on intersphincter drainage in treatment of perianal abscess[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(06):39-45.
朱煜璋,李鹏,李小嘉等.括约肌间引流术治疗肛周脓肿的临床观察[J].上海中医药大学学报,2022,36(06):39-45. DOI： 10.16306/j.1008-861x.2022.06.007.

ZHU Yuzhang,LI Peng,LI Xiaojia,et al.Clinical observation on intersphincter drainage in treatment of perianal abscess[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(06):39-45. DOI： 10.16306/j.1008-861x.2022.06.007.

摘要

目的,2,比较括约肌间引流术与单纯切开引流术治疗肛周脓肿的有效性、安全性与卫生经济学指标。,方法,2,纳入90例肛周脓肿患者，随机分为研究组与对照组，每组各45例。研究组患者采用括约肌间引流术治疗，对照组患者采用单纯切开引流术治疗。术后随访3个月，比较两组患者的术后肛瘘形成率、肛周脓肿复发率与创面愈合时间；术后，评价两组患者的肛门疼痛、创面分泌物渗出情况、发热情况、首次排尿情况评分；术后3个月，评价两组患者的肛门功能评估表（Wexner）评分及肛门形态外观评分；比较两组患者的住院时间与住院费用。,结果,2,①研究组患者的肛周脓肿复发率为0%、对照组为6.67%，两组患者的复发率比较，差异无统计学意义（,P,>,0.05）；研究组患者的肛瘘形成率为22.2%、对照组为48.9%，研究组患者的肛瘘形成率低于对照组（,P,<,0.01）；研究组患者的创面愈合时间较对照组明显缩短（,P,<,0.01）。②术后第3、7天，两组患者的肛门疼痛视觉模拟量表（VAS）评分比较，差异有统计学意义（,P,<,0.05，,P,<,0.01），研究组患者的肛门疼痛情况优于对照组；术后第3天，两组患者的创面分泌物渗出情况评分比较，差异有统计学意义（,P,<,0.05），研究组患者的创面分泌物渗出情况优于对照组；术后，两组患者的发热情况评分比较，差异均无统计学意义（,P,>,0.05）；两组患者的术后首次排尿情况评分比较，差异具有统计学意义（,P,<,0.05），研究组患者的术后首次排尿情况优于对照组。③术后3个月，两组患者的Wexner评分、肛门形态外观评分比较，差异均无统计学意义（,P,>,0.05）。④研究组患者的住院天数较对照组明显缩短（,P,<,0.05），住院费用较对照组明显减少（,P,<,0.01）。,结论,2,与单纯切开引流术相比，括约肌间引流术治疗肛周脓肿具有较好的临床疗效与安全性，且术后并发症轻，卫生经济效益更好。

Abstract

Objective： To compare the efficacy， safety and health economic indicators between intersphincteric drainage and simple incision drainage in the treatment of perianal abscess.,Methods,2,A total of 90 patients with perianal abscess were included and randomly divided into the study group and the control group， 45 cases in each group. The patients in the study group were treated with intersphincter drainage， and the patients in the control group were treated with simple incision drainage. Follow-up for 3 months after surgery， the formation rate of anal fistula， recurrence rate of perianal abscess and wound healing time were compared between the two groups. After surgery， the scores of anal pain， wound secretion exudation， fever and the first urination were evaluated. Three months after surgery， the scores of anal function assessment scale （Wexner） and anal appearance in the two groups were evaluated. The hospitalization time and cost were compared between the two groups.,Results,2,①The recurrence rate of perianal abscess was 0% in the study group and 6.67% in the control group， and there was no statistically significant difference on the recurrence rate between the two groups （,P,>,0.05）. The formation rate of anal fistula was 22.2% in the study group and 48.9% in the control group， and the formation rate of anal fistula in the study group was lower than that in the control group （,P,<,0.01）. The wound healing time of the study group was significantly shorter than that of the control group （,P,<,0.01）. ②On the 3rd and 7th days after surgery， there was statistically significant difference on the visual analogue scale （VAS） score of anal pain between the two groups （,P,<,0.05， ,P,<,0.01）， and the anal pain condition of the study group was superior to the control group. On the 3rd day after surgery， there was statistically significant difference on the score of wound secretion exudation between the two groups （,P,<,0.05）， and the wound secretion exudation condition of the study group was superior to the control group. After surgery， there was no statistically significant difference on the score of fever between the two groups （,P,>,0.05）. There was statistically significant difference on the score of postoperative first urination between the two groups （,P,<,0.05）， and the postoperative first urination condition of the study group was superior to the control group. ③Three months after surgery， there were no statistically significant differences on the Wexner score and the anal appearance score between the two groups （,P,>,0.05）. ④The hospitalization time of the study group was significantly shorter than that of the control group （,P,<,0.05）， and the hospitalization cost of the study group was significantly less than that of the control group （,P,<,0.01）.,Conclusion,2,Compared with simple incision drainage， intersphincter drainage has better therapeutic effect and safety in the treatment of perianal abscess， and its postoperative complications is mild， the health economic benefits are better.

关键词

肛周脓肿括约肌间引流术括约肌保留临床疗效

Keywords

perianal abscessintersphincter drainagesphincter preservationclinical efficacy

references

郭其乐，王琛，姚向阳. 拖线置管术联合灌注冲洗后中药拖线换药治疗高位马蹄形肛周脓肿28例［J］. 中国医药指南，2018， 16（16）： 48-49.

裴景慧，王琛，黄河，等. 顾氏外科“早期置管引流后期负压吸引”治疗深部肛周脓肿临床研究［J］. 世界中医药，2017， 12（11）： 2651-2654， 2658.

赖日东，刘爱红，陈少红. 高位肛周脓肿的手术治疗进展［J］. 海南医学，2012， 23（23）： 122-125.

汪建平. 中华结直肠肛门外科学［M］. 北京：人民卫生出版社， 2014： 767-774.

中国医师协会肛肠医师分会指南工作委员会. 肛周脓肿临床诊治中国专家共识［J］. 中华胃肠外科杂志， 2018， 21（4）： 456-457.

YANO T， ASANO M， MATSUDA Y， et al. Prognostic factors for recurrence following the initial drainage of an anorectal abscess［J］. Int J Colorectal Dis， 2010， 25（12）： 1495-1498.

卢丹. 肛周脓肿术后复发危险因素的研究［D］. 上海：上海中医药大学， 2019.

HE Z， DU J， WU K， et al. Formation rate of secondary anal fistula after incision and drainage of perianal sepsis and analysis of risk factors［J］. BMC Surg， 2020， 20（1）： 94.

KARCIOGLU O， TOPACOGLU H， DIKME O， et al. A systematic review of the pain scales in adults： Which to use？［J］. Am J Emerg Med， 2018， 36（4）： 707-714.

孙健，林晖，张宸，等. 括约肌间入路加隧道式拖线引流术治疗马蹄型肛周脓肿的临床研究［J］. 上海中医药杂志，2020， 54（2）： 74-77.

黄仁燕，郑德，徐菲，等. 经直肠超声引导下穿刺置管引流治疗高位肛周脓肿的临床观察［J］. 第二军医大学学报，2018， 39（11）： 1230-1234.

RUSAVY Z， JANSOVA M， KALIS V. Anal incontinence severity assessment tools used worldwide［J］. Int J Gynaecol Obstet， 2014， 126（2）： 146-150.

HANADA M， FURUYA T， SUGITO K， et al. Evaluation of the efficacy of incision and drainage versus hainosankyuto treatment for perianal abscess in infants： a multicenter study［J］. Surg Today， 2015， 45（11）： 1385-1389.

OMMER A， HEROLD A， BERG E， et al. German S3 guidelines： anal abscess and fistula （second revised version）［J］. Langenbecks Arch Surg， 2017， 402（2）： 191-201.

金黑鹰，章蓓. 实用肛肠病学［M］. 上海：上海科学技术出版社，2014： 155-166.

PEARCE L， NEWTON K， SMITH S R， et al. Multicentre observational study of outcomes after drainage of acute perianal abscess［J］. Br J Surg， 2016， 103（8）： 1063-1068.

毛红. 肛周脓肿发病的中西医认识［J］. 中国中医药现代远程教育， 2013， 11（14）： 138-140.

张心怡，金黑鹰. 肛周脓肿三间隙引流术的理论基础及临床应用进展［J］. 世界华人消化杂志，2019， 27（13）： 791-797.

ROSEN S A， COLQUHOUN P， EFRON J， et al. Horseshoe abscesses and fistulas： how are we doing？［J］. Surg Innov， 2006， 13（1）： 17-21.

Views

191

下载量

CSCD

CNKI被引量

Alert me when the article has been cited

提交

Tools

Publicity Resources

Clinical efficacy of Yanghe Decoction in patients with breast cancer receiving neo⁃adjuvant chemotherapy and its impact on inflammatory factors

Clinical observation of Lujiao Zhuangdu Decoction in treating ankylosing spondylitis

Clinical observation of Fuyuan Tongluo Formula in treatment of stent implantation and restenosis of diabetic lower limb vascular disease

Efficacy observation of Xiaozhong Kuiyong Recipe on postoperative wound healing of perianal abscess with syndrome of exuberance of heat-toxicity

Clinical Efficacy Evaluation of Jianpi Jiedu Recipe in the Treatment of Advanced Colorectal Cancer with Syndrome of Dampness-heat Due to Spleen Deficiency

Related Author

No data

Related Institution

Department of Breast Disease， Yueyang Hospital of Integrated Traditional Chinese and Western Medicine， Shanghai University of Traditional Chinese Medicine

Rheumatology Department， Shanghai Hospital of Traditional Chinese Medicine， Shanghai University of Traditional Chinese Medicine

Department of Peripheral Vascular Diseases， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Department of Proctology Surgery,Gongli Hospital of Pudong New Area

Department of Chinese Medicine,Shanghai Puxing Community Health Service Center,Pudong New Area

⁰