青枝方坐浴辅助经肛括约肌间切开术(TROPIS)治疗急重疑难性高位肛周脓肿的临床观察
Clinical Study on the Treatment of Acute,Severe,and Difficult High Perianal Abscesses by Qingzhi Decoc-tion Sitz Bath Assisted Transanal Sphincterotomy(TROPIS)
廖波 1彭位俊 1王小婉 1张桢 1王镇澜2
作者信息
- 1. 重庆市中医院,重庆 400021
- 2. 重庆大学附属三峡医院,重庆 408099
- 折叠
摘要
目的 观察青枝方坐浴辅助经肛括约肌间切开术(TROPIS)治疗急重疑难性高位肛周脓肿的临床疗效.方法 80例伴有脓毒症的高位肛周脓肿患者随机分为观察组与对照组各40例.观察组采用青枝方坐浴辅助TROPIS治疗,对照组采用主流术式切开挂线术联合高锰酸钾坐浴治疗.比较两组患者术中出血量、术后疼痛持续时间、创面愈合时间、住院时间、术后脓肿复发率、成瘘率及术后2个月、3个月肛门功能等情况.结果 观察组术中出血较对照组少,术后疼痛持续时间、创面愈合时间、住院时间均较对照组短(P＜0.05).观察组在术后2个月、术后3个月的肛门失禁Wexner评分均低于对照组(P＜0.05).两组患者术后3个月脓肿复发率及成瘘率比较,差异无统计学意义(P＞0.05).结论 青枝方坐浴辅助TROPIS治疗高位肛周脓肿效果确切,而且对肛门括约肌的损伤更小,术中出血少,术后疼痛轻,对肛门功能及肛门形态的保护更好,创面愈合快,住院时间短,值得临床应用推广.
Abstract
Objective:To observe the clinical effect of Qingzhi Decoction sitz bath assisted transanal sphincterot-omy(TROPIS)in the treatment of acute,severe,and difficult high perianal abscess.Methods:A total of 80 pa-tients with high perianal abscess accompanied by sepsis were randomly divided into an observation group and a control group,with 40 cases in each group.The observation group was treated with Qingzhi Decoction sitz bath as an auxiliary treatment for TROPIS,while the control group was treated with mainstream surgical incision and thread-drawing surgery combined with potassium permanganate sitz bath.The intraoperative blood loss,postopera-tive pain duration,wound healing time,hospital stay,postoperative abscess recurrence rate,fistula formation rate,and anal function at 2 and 3 months after surgery between two groups were compared.Results:The observation group had less intraoperative bleeding compared with the control group,and the duration of postoperative pain,wound healing time,and hospitalization time were all shorter than those of the control group(P＜0.05).The Wexner scores of anal incontinence in the observation group were lower than those in the control group at 2 and 3 months after surgery(P＜0.05).There was no statistically significant difference in the recurrence rate of abscess and anal fistula formation rate between the two groups of patients at 3 months after surgery(P＞0.05).Conclu-sion:Qingzhi Decoction sitz bath assisted TROPIS has a definite effect on the treatment of high perianal abscess,with less damage to the anal sphincter,less intraoperative bleeding,mild postoperative pain,better protection of anal function and morphology,fast wound healing,and short hospital stay,which is worthy of clinical application and promotion.
关键词
高位肛周脓肿/经肛括约肌间切开术/青枝方/中药坐浴Key words
High perianal abscess/Transanal sphincterotomy/Qingzhi Decoction/TCM sitz bath引用本文复制引用
基金项目
重庆市科卫联合医学科研项目(2022QNXM075)
重庆市科研机构绩效激励引导专项(jxyn2021-2-14)
重庆市科卫联合医学科研项目(2022MSXM163)
出版年
2024
NETL
NSTL
维普
万方数据