世界中医药

作者	单位
裴景慧1，王琛1，黄河2，曹永清1，陆金根1	1 上海中医药大学附属龙华医院肛肠科，上海，200032； 2 温州市中心医院肛肠科，温州，325000

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中文摘要:

目的：评价顾氏外科特色疗法“早期置管引后期负压吸引”治疗深部肛周脓肿的疗效和安全性。方法：采用队列研究的方法，自2014年1月至2015年12月分别在上海中医药大学附属龙华医院和温州市中心医院肛肠科治疗的深部肛周脓肿住院患者。观察组采用“早期置管引流后期负压吸引法”，对照组采用“切开挂线法”。观察指标包括患者一般情况、实验室和影像学检查、脓肿性质、内口情况、愈合率、愈合时间、脓肿复发及瘘管形成情况等。结果：共59例深部肛周脓肿患者接受手术治疗并完成6月随访，其中观察组29例，平均年龄38.86岁，男/女为26/3，有明显内口者14例。对照组30例，平均年龄43.3岁，男/女为26/4，有明显内口者16例。观察组和对照组经治疗后：总体愈合率51.7% vs 46.7%，平均愈合时间32.8 d vs 43.1 d(P<0.05)，脓肿复发率13.8% vs 23.3%，瘘管形成率48.3% vs 53.3%，复杂性肛瘘的发生率24.1%vs.36.7%。2组患者术后Wexner肛门失禁功能评分0.48 vs 1.67(P<0.05)。结论：顾氏外科特色疗法“早期置管引流后期负压吸引”是治疗深部肛周脓肿安全有效的方法，相对经典切开挂线术愈合率和复发率相当，但愈合时间短，对肛门功能保护好。

English Summary:

To observe the efficacy and safety of Gu's surgical treatment “catheter drainage with negative Pressure suction” in deep anorectal abscess. Methods:A Cohort study was conducted among patients with deep anorectal abscess in Longhua hospital and Wenzhou central hospital(from January 2015 to December 2015). There were in total of 59 cases. Patients were divided in to treatment group (29 cases, average age 38.86, male/female 26/3) which was treated with “catheter drainage with negative Pressure suction” method, and control group (30 cases, average age 43.3, male/female 26/4) which was treated with incision-thread-drawing method. To observe the general situation, imaging, abscess, IO, healing rate, healing duration, relapse as well as fistula formation. Results:Total effective rate of the treatment group and control group is 51.7% and 46.7% respectively, duration 32.8 d and 43.1 d (P<0.05), recurrence rate 13.8% and 23.3%, fistula occurrence rate 48.3% and 53.3%, ratio of complicated fistula 24.1% and 36.7%, and Wexner score 0.48 and 1.67 (P<0.05). Conclusion:Gu's treatment “Catheter drainage with negative pressure suction” is effective and safe. Compared to rational method, it has a shorter healing duration which helps anorectal function recovery.

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