世界中医药

基金项目:上海市卫生和计划生育委员会青年科研项目“拖线置管术治疗高位复杂性肛瘘临床研究”(编号：20134Y054）；上海市科委科研计划项目“拖线置管垫棉综合疗法治疗复杂性肛瘘的多中心临床研究”(编号：13401903001）；海派中医流派传承研究基地-顾氏外科流派传承工作（编号：ZYSNXD-CC-APGC-JD002），国家中医药管理局重点学科-肛肠学科资助（编号：561）；上海市杏林新星计划（编号：ZY3-RCPY-2-2002）

作者	单位
梁宏涛，姚一博，沈晓，陶晓春，曹永清，陆金根	上海中医药大学附属龙华医院肛肠科，上海，200032

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中文摘要:

目的：评价拖线置管术治疗高位复杂性肛瘘的有效性及安全性。方法：采用前瞻性、随机、对照的试验设计，以切开挂线术为对照，以愈合天数及内、外括约肌缺损长度为主要疗效指标，以治愈率、复发率、疼痛为次要疗效指标，以Wexner量表评估结合不良事件为安全性指标。结果：本研究入组76例病例，有效72例，治疗组与对照组各36例。创面愈合时间治疗组短于对照组；内、外括约肌缺损长度治疗组短于对照组；术后第10 d疼痛治疗组轻于对照组（P<0.05）。2组治愈率、复发率，及治疗组、对照组的愈合时、愈合后3月时Wexner量表评估与自身术前及组间差异无统计学意义（P>0.05）。2组均无与治疗相关的不良事件发生。结论：拖线置管术治疗高位复杂性肛瘘具有治愈时间短，内、外括约肌损伤少，痛苦小的优势。

English Summary:

To evaluate the clinical efficacy and safety of treating high complex anal fistulae by suture dragging and catheter drainage.Methods：It was a prospective and randomized controlled trial study. In this study we enrolled 76 cases， and effective in 72 cases finally， 36 cases in each group. The patients in the control group were treated by incision and ligation therapy. The primary outcomes were healing time， and the damage of internal and external sphincter， meanwhile healing rate， recurrence rate， postoperative pain served as secondary indexes. The safety index was observed by Wexner scale evaluation and adverse events.Results：The healing time in the treatment group was significant shorter than that of the control group， the treatment group made significant lesser damage of internal sphincter and external sphincter than the control group. The postoperative pain on the 10th day was significant lower than that of the control group (P<0.05). No significant difference were found on healing rate， recurrence rate， and evaluation at each observation point of Wexner scale between the two group (P>0.05). Both groups had no adverse events related to the treatment.Conclusion：The treatment of suture dragging and catheter drainage has advantages such as shorter healing time， lesser damage of sphincter， and lower postoperative pain.

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