Citation: | CHENG Sijun, YUAN Xuegang, YIN Hongmei, WU Jia, MA Chuanming, WANG Xin, PU Yongping, CHEN Yiming, YANG Yumei. Effect of transanal opening of intersphincteric space modified thread-drawing method and incision thread-drawing surgery in treatment of high anal fistula[J]. Journal of Clinical Medicine in Practice, 2023, 27(19): 107-110. DOI: 10.7619/jcmp.20232295 |
To investigate the efficacy of transanal opening of intersphincteric space (TROPIS) modified thread-drawing method and incision thread-drawing surgery in treatment of high anal fistula and its effects on pain index, wound area, anal function and postoperative complications.
A total of 88 patients with high anal fistula were selected as the research subjects. They were randomly divided into control group (44 cases, using incision thread-drawing surgery) and observation group (44 cases, using TROPIS modified thread-drawing method). The postoperative efficacy, perioperative indexes, wound recovery, pain index, anal function and postoperative complications were compared between the two groups.
After treatment, the total clinical effective rate of the observation group was significantly higher than that of the control group (P < 0.05). Wound healing, hematochezia, pus shedding, operation and hospitalization time in the observation group were significantly smaller than those in the control group, and wound scar area was significantly smaller than that in the control group (P < 0.05). After 1 day and 7 days of treatment, the pain score of the observation group was significantly lower than that of the control group (P < 0.05). The scores of gas, liquid and solid incontinence, hygiene pad use and lifestyle change in the observation group were significantly lower than those in the control group (P < 0.05). The total complication rate of the observation group was significantly lower than that of the control group (P < 0.05).
Compared with incision thread-drawing surgery, TROPIS modified thread-drawing method is effective in treatment of high anal fistula, which can relieve postoperative pain and improve the anal function of patients, and the risk of complications is low.
[1] |
张凤琼, 张志云, 高爽, 等. TROPIS联合改良Hanley术治疗高位经括约肌肛瘘的临床疗效[J]. 中南医学科学杂志, 2022, 50(6): 894-897. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYY202206028.htm
|
[2] |
陈宁, 刘思义, 耿彪. 低位挂线引流加高位挂线切割术对复杂性高位肛瘘病人的治疗作用及对病人术后复发率的影响[J]. 中南医学科学杂志, 2018, 46(2): 160-162. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYY201802013.htm
|
[3] |
王建忠, 赵晨翔, 师九平, 等. 低位实挂线高位虚实结合挂线法治疗高位肛瘘的临床效果[J]. 中国中西医结合外科杂志, 2023, 29(2): 166-169. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZX202302006.htm
|
[4] |
吴闯, 徐进, 汪庆明, 等. 改良经括约肌间瘘管结扎术治疗括约肌间型及经括约肌型肛瘘的临床效果研究[J]. 中国中西医结合外科杂志, 2023, 29(2): 156-160. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZX202302004.htm
|
[5] |
王燕, 侯毅, 郑雪平, 等. 经括约肌间入路TROPIS改良挂线法治疗高位肛瘘的临床效果[J]. 中国中西医结合外科杂志, 2023, 29(2): 161-165. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZX202302005.htm
|
[6] |
中国医师协会肛肠医师分会临床指南工作委员会. 肛瘘诊治中国专家共识(2020版)[J]. 中华胃肠外科杂志, 2020, 23(12): 1123-1130.
|
[7] |
梁文杰, 方朝义, 沈莉, 等. 实验诊断学在现行《中医病证诊断疗效标准》中的应用分析[J]. 河北中医药学报, 2011, 26(2): 47-48. https://www.cnki.com.cn/Article/CJFDTOTAL-HZYX201102035.htm
|
[8] |
高万露, 汪小海. 视觉模拟疼痛评分研究的进展[J]. 医学研究杂志, 2013, 42(12): 144-146. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYZ201312048.htm
|
[9] |
石玉迎, 郑丽华, 张文, 等. 高位肛瘘虚实结合挂线术后肛管直肠3D测压及肛门失禁WEXNER评分结果探讨[J]. 中国临床医生杂志, 2019, 47(9): 1076-1078. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS201909026.htm
|
[10] |
徐雷涛, 王钟磊. 小切口外痔剥离加内痔结扎术治疗环状混合痔的效果及对患者肛门功能的影响[J]. 临床医学研究与实践, 2021, 6(8): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS202108029.htm
|
[11] |
栗鸿民, 杜忠卫, 张印斗, 等. 保留灌肠插管MRI增强扫描在高位复杂性肛瘘中的诊断价值[J]. 中国医师进修杂志, 2023, 46(3): 276-280.
|
[12] |
娄舒萍, 孙国钢, 黄飞鹰, 等. 两种不同术式治疗高位肛瘘的临床效果及安全性对比[J]. 浙江创伤外科, 2022, 27(4): 767-768. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJCW202204069.htm
|
[13] |
刘墩, 刘宁远, 郭红鑫, 等. 虚实结合挂线术与传统切开挂线术治疗高位肛瘘的疗效比较[J]. 中国临床医生杂志, 2023, 51(2): 222-224. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS202302027.htm
|
[14] |
侯毅, 郑雪平, 谭妍妍, 等. 改良TROPIS术对高位肛瘘患者术后肛门功能的长期影响与危险因素分析[J]. 天津医药, 2023, 51(1): 86-91. https://www.cnki.com.cn/Article/CJFDTOTAL-TJYZ202301017.htm
|
[15] |
解雯, 郑雪平, 郭高正, 等. 改良TROPIS联合置管引流术治疗复杂性肛瘘的疗效及安全性研究[J]. 中华结直肠疾病电子杂志, 2022, 11(2): 114-119.
|
[16] |
陈鑫球, 任悦怡, 李玉英, 等. 经肛括约肌间切开术(TROPIS)治疗高位括约肌间型肛瘘的临床疗效分析[J]. 结直肠肛门外科, 2022, 28(5): 479-481, 487. https://www.cnki.com.cn/Article/CJFDTOTAL-DCGM202205011.htm
|
[17] |
郑雪平, 郭高正, 樊志敏, 等. 基于括约肌间感染机制经肛括约肌间切开术治疗高位肛瘘临床研究[J]. 重庆医学, 2022, 51(1): 85-88, 92. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202201018.htm
|
[18] |
郭高正, 郑雪平, 谭妍妍, 等. 2种经括约肌间入路术式治疗高位单纯性肛瘘的对比分析[J]. 天津医药, 2021, 49(5): 534-538. https://www.cnki.com.cn/Article/CJFDTOTAL-TJYZ202105018.htm
|
[19] |
王燕, 孙娟玲, 张如洁, 等. 克罗恩病合并肛瘘的治疗研究进展[J]. 空军军医大学学报, 2022, 43(7): 765-768, 773. https://www.cnki.com.cn/Article/CJFDTOTAL-DSJY202207022.htm
|
[20] |
戴洛. 肛裂切除术联合外括约肌切断术治疗慢性肛裂的临床疗效[J]. 实用临床医药杂志, 2016, 20(21): 120-121. doi: 10.7619/jcmp.201621043
|
[21] |
沈晓明, 刘如钱, 鲍传庆. 腹腔镜下全直肠系膜切除术联合经肛管括约肌间切除术在超低位直肠癌保肛手术中的应用效果分析[J]. 实用临床医药杂志, 2017, 21(17): 131-132. doi: 10.7619/jcmp.201717042
|