改良微创根治术治疗高位复杂性肛瘘的临床研究.pdf

摘 要 目的：高位复杂性肛瘘目前治疗以手术为主，但手术难度大，术后复发率高，并发症、 后遗症多。如何从真正意义上减少复发，提高疗效，保护肛门节制功能，保持肛门形 态和功能的完整性等有待进一步的研究和探索。本课题旨在通过改良微创根治术治疗 高位复杂肛瘘的临床研究，找寻一种具有创伤小，愈合时间短，肛门括约功能完好且 能治愈高位复杂性肛瘘的的手术方式。 方法：选择40 例高位复杂性肛瘘患者，经分析随机分为2 组，试验组20 例和对照组 20 例，试验组采用改良微创根治术，对照组采用传统内挂外切术治疗。观察两组术 后患者疼痛、愈合时间、创面面积情况、总体疗效、复发率及术后肛门功能及形态。 随访半年，采用SPSS13.O 统计学软件进行分析，组间数据比较采用t 检验，百分率 2 比较采用x 检验，以P0.05 为差异有显著性意义。 结果：两组在疼痛、愈合时间、创面面积情况、总体疗效及保护肛门括约功能方面有 显著性差异(P0 ．05) 。在治愈率和复发率方面两组无显著性差异(PO ．05) 。 结论：与传统的内挂外切术相比，改良微创根治术治疗高位复杂肛瘘在减少手术创伤， 术后病程短，肛门功能完好，避免术后产生后遗症方面具有显著的优越性。通过改良 微创根治术可以有效地减轻术后病人的痛苦，加快伤口愈合、缩短治疗时间，减轻病 者的医药费负担等问题。 关键词：高位复杂肛瘘；微创； 临床研究 Improved minimally invasive radical treatment for high complex anal fistula of Clinical Research Abstract Objective: High complex anal fistula treatment at present is given priority to with surgery, but the surgery is difficult, and the postoperative recurrence rate is high, with more complications and sequelae. How to truly reduce recurrence and improve curative effect, protecting anal control function, maintaining anal morphology and function remains to be further research and exploration .This research with improve minimally invasive radical treatment for high complex anal fistula, aims to looking for an operation method which is A small trauma, shorter healing time, good anal closure function and can cure high complexity anal fistula. Methods: Choose 40 cases with high complicated anal fistula patients, through the analysis of randomly divided into 2 groups, treatment group 20 patients and 20 cases in control group, experimental group use improved minimally invasive radical prostatectomy, the control group use traditional low cut and high treatment . Observe the two groups of patients wit