| 张凤琼,张志云,高爽,陈康,王晓岚,邓婷婷,袁鹏飞,陈琴.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,(6):894-897. |
| TROPIS联合改良Hanley术治疗高位经括约肌肛瘘的临床疗效 |
| Clinical efficacy of TROPIS combined with modified Hanley operation for high transsphincteric fistula |
| 投稿时间：2021-12-26 修订日期：2022-09-11 |
| DOI：10.15972/j.cnki.43-1509/r.2022.06.028 |
| 中文关键词: 经肛括约肌间切开术 改良Hanley术 高位经括约肌肛瘘 [ |
| 英文关键词:transanal opening of intersphincteric space modified hanley operation high transsphincter fistula |
| 基金项目:昆明市科技计划项目(2019-1-S-25318000001509) 作者简介:张凤琼,住院医师,研究方向为肛肠疾病的诊断与治疗,E-mail为zzy15368086827@163.com。通信作者张志云,副主任医师,研究方向为肛肠疾病的诊断与治疗,E-mail为1494795697@qq.com。 |
| 作者 | 单位 | E-mail | | 张凤琼 | 昆明市中医医院肛肠科,云南省昆明市650011 | e-mail为zzy15368086827@163.com,e-mail为1494795697@qq.com | | 张志云 | 昆明市中医医院肛肠科,云南省昆明市650011 | e-mail为zzy15368086827@163.com,e-mail为1494795697@qq.com | | 高爽 | 昆明市中医医院肛肠科,云南省昆明市650011 | | | 陈康 | 昆明市中医医院肛肠科,云南省昆明市650011 | | | 王晓岚 | 昆明市中医医院肛肠科,云南省昆明市650011 | | | 邓婷婷 | 昆明市中医医院肛肠科,云南省昆明市650011 | | | 袁鹏飞 | 昆明市中医医院肛肠科,云南省昆明市650011 | | | 陈琴 | 昆明市中医医院肛肠科,云南省昆明市650011 | |
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| 中文摘要: |
| 目的观察经肛括约肌间切开术(TROPIS)联合改良Hanley术治疗高位经括约肌肛瘘的临床疗效。 方法将本院收治的高位经括约肌肛瘘患者100例均分为观察组(TROPIS联合改良Hanley术治疗)和对照组(传统切开挂线术治疗)。记录两组肛门疼痛、渗出和肿胀评分,比较两组肛肠动力学指标、创面愈合时间、便血时间、脓腐脱落时间、创面瘢痕面积、血清炎症因子和免疫功能水平。 结果两组术后7天肛门疼痛、渗出和肿胀评分较术后1天降低,且观察组均低于对照组(P＜0.05)；两组术后直肠静息压、肛管静息压水平较术前降低,观察组高于对照组(P＜0.05)；观察组术后创面愈合时间、便血时间、脓腐脱落时间、创面瘢痕面积均低于对照组(P＜0.05)；两组术后TNF-α、IL-6、IL-8和CRP水平较术前升高,且观察组低于对照组(P＜0.05)；观察组术后CD3+、CD4+、CD4+/CD8+比值和NK细胞水平高于对照组(P＜0.05)。 结论TROPIS联合改良Hanley术,创伤更小,可减轻炎症反应,有利于机体免疫功能的恢复。 |
| 英文摘要: |
| To observe the clinical efficacy of transsphincterotomy (TROPIS) combined with modified Hanley procedure in the treatment of high transsphincteric fistula. MethodsA total of 100 patients with high transsphincter anal fistula admitted to our hospital were divided into observation group (TROPIS combined with modified Hanley surgery) and control group (traditional incision and suture hanging). The anal pain, exudation and swelling scores of the two groups were recorded, and anorectal motility indexes, wound healing time, hematochezia time, pus shedding time, scar area of the wound, serum inflammatory factors and immune function levels were compared between the two groups. ResultsOn the 7th day after operation, the scores of anal pain, exudation and swelling in the two groups were lower than those on the 1st day after operation, and those in the observation group were lower than those in the control group (P＜0.05). The levels of rectal resting pressure and anal canal rest pressure in the two groups after operation were lower than those before operation, and the observation group was higher than that in the control group (P＜0.05). After operation, the wound healing time, hematochezia time, pus shedding time and wound scar area of the observation group were lower than those of the control group (P＜0.05). The levels of TNF-α, IL-6, IL-8 and CRP in the two groups after operation were higher than those before operation, and the observation group was lower than the control group (P＜0.05). After operation, the levels of CD3+, CD4+, CD4+/CD8+ ratio and NK cells in the observation group were higher than those in the control group (P＜0.05). ConclusionTransanal intersphincterotomy combined with modified Hanley surgery has less trauma, can reduce inflammation, and is benfical to the recovery of immune function. |
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