目的 分析三间隙引流术、单纯切开引流术与切开挂线引流术治疗肛周脓肿的疗效及对术后疼痛、创面愈合及肛门功能的影响.方法 2020年6月～2023年6月收治的肛周脓肿病人100例,根据术式不同分为3组:A组34例,行三间隙引流术治疗;B组33例,行单纯切开引流术治疗;C组33例,行切开挂线引流术治疗.比较3组病人治疗疗效、术后创面愈合情况(腐肉完全脱落、创面愈合).比较术后1天、7天、14天3组病人疼痛情况[视觉模拟疼痛评分(VAS)]、肛门功能(Wexner肛门失禁量表评分)、术后14天3组病人并发症总发生率(感染、肛瘘、肛门畸形).结果 A组治疗总有效率(94.12％)高于B组(75.76％)、C组(69.70％),差异有统计学意义(P＜0.05)o A组病人的腐肉完全脱落时间、创面愈合时间[(15.41±2.07)天、(20.97±2.33)天]均短于 B 组[(17.29±2.13)天、(22.65±2.64)天]、C 组[(18.54±2.16)天、(23.99±2.61)天],差异有统计学意义(P＜0.05).术后1天、7天、14天,A组病人VAS评分、Wexner肛门失禁量表评分均低于B组、C组,差异有统计学意义(P＜0.05).术后14天,A组病人的感染、肛瘘、肛门畸形总发生率(8.82％)低于B组(21.21％)、C组(21.21％),但差异无统计学意义(P＞0.05).结论 三间隙引流术治疗肛周脓肿效果显著,可减轻病人术后疼痛感,促进创面愈合和肛门功能恢复.
Efficacy of three-cavity clearance,simple incision and drainage and incision thread drawing procedure on patients with perianal abscess and its influence on postoperative pain,wound healing and anal function recovery
Objective To analyze the efficacy of three-cavity clearance,simple incision and drainage and incision thread drawing procedure in the treatment of patients with perianal abscess and its influence on postoperative pain,wound healing and anal function recovery.Methods 100 patients with perianal abscess in our hospital were included from June 2020 to June 2023.According to different surgical methods,they were divided into group A(n=34,three-cavity clearance),group B(n=33,simple incision and drainage)and group C(n=33,incision thread drawing procedure).The therapeutic effect and postoperative wound healing of the three groups were compared(completely shedding of carrion and wound healing).The pain status[visual analogue pain scale(VAS)]and anal function(Wexner Anal incontinence Scale score)of the 3 groups were compared at 1,7 and 14 days after surgery.The total incidence of complications(infection,anal fistula and anal deformity)in the 3 groups were compared at 14 days after surgery.Results The total therapeutic efficacy rate in group A(94.12％)was significantly higher than that in group B(75.76％)and group C(69.70％)(P＜0.05).The complete shedding of carrion and wound healing time with(15.41±2.07)d,(20.97±2.33)d in group A were significantly shorter than(17.29±2.13)d,(22.65±2.64)d in group B and(18.54±2.16)d,(23.99±2.61)d in group C(P＜0.05).At 1,7 and 14 days after surgery,the VAS score and Wexner Incontinence scale score in group A were significantly lower compared with those in group B and group C(P＜0.05).Within 14 days after surgery,the total incidence rate of infection,anal fistula and anal deformity in group A(8.82％)was lower compared to group B(21.21％)and group C(21.21％)(P＞0.05).Conclusion Three-cavity clearance has a significant effect in the treatment of patients with perianal abscess,and it can relieve the postoperative pain,and promote the wound healing and anal function recovery.
three-cavity clearancesimple incision and drainageincision thread drawing procedureperianal abscesspostoperative painanal function
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