本文關(guān)鍵詞：肛瘺瘺管剔除與對(duì)口引流保留皮橋術(shù)聯(lián)合應(yīng)用治療單純性肛瘺的臨床效果觀(guān)察　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 對(duì)口引流保留皮橋術(shù) 肛瘺瘺管剔除 單純性肛瘺 肛瘺瘺管切除術(shù) 肛門(mén)功能

【摘要】：目的:比較肛瘺瘺管剔除聯(lián)合對(duì)口引流保留皮橋術(shù)與肛瘺瘺管切除術(shù)在單純性肛瘺治療的臨床效果,探討肛瘺瘺管剔除聯(lián)合對(duì)口引流保留皮橋術(shù)在臨床治療單純性肛瘺的優(yōu)勢(shì)。方法:選取2015年5月至2016年5月在遷安市人民醫(yī)院接受手術(shù)治療且符合研究條件的肛瘺患者,將其隨機(jī)分為治療組和對(duì)照組,治療組50例,手術(shù)方式為肛瘺瘺管剔除聯(lián)合對(duì)口引流保留皮橋術(shù);對(duì)照組50例,手術(shù)方式為肛瘺瘺管切除術(shù);患者隨訪(fǎng)時(shí)間為6個(gè)月,觀(guān)察并記錄兩組患者術(shù)后疼痛、排尿、創(chuàng)面出血、住院時(shí)間、傷口愈合時(shí)間、術(shù)后傷口有無(wú)感染、肛門(mén)功能、治療療效;出院后隨訪(fǎng)6個(gè)月,了解肛瘺的復(fù)發(fā)情況,討論此研究中所采用治療方式的安全性和有效性。結(jié)果:1對(duì)比兩組患者住院時(shí)間,治療組(13.2±2.6)天比對(duì)照組(19.4±6.2)天,其住院時(shí)間得到明顯性縮短,將數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,數(shù)據(jù)有統(tǒng)計(jì)學(xué)意義(P0.05);2對(duì)比兩組患者傷口愈合時(shí)間,治療組(16.2±2.6)天比對(duì)照組(25.3±5.9)天,采用統(tǒng)計(jì)學(xué)分析得知,組間數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義(P0.05),表明治療組所采用的方式可將傷口愈合時(shí)間明顯縮短;3治療組患者術(shù)后感染率4%比對(duì)照組6%低,但經(jīng)統(tǒng)計(jì)學(xué)分析,組間數(shù)據(jù)無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);4對(duì)比兩組患者術(shù)后疼痛指標(biāo),治療組術(shù)后當(dāng)日、術(shù)后十四天時(shí)評(píng)分別為(4.4±1.1)分、(0.0±0.0)分,對(duì)照組評(píng)分為(5.3±1.3)分、(1.3±0.5)分,此兩組數(shù)據(jù)對(duì)比,有統(tǒng)計(jì)學(xué)意義(P0.05);但對(duì)比兩組患者術(shù)后三天、術(shù)后七天時(shí),治療組(3.1±1.2)分、(1.5±0.8)分,對(duì)照組(3.3±0.8)分、(1.9±1.4)分,組間數(shù)據(jù)無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);5對(duì)比兩組患者術(shù)后導(dǎo)尿率、肌肉注射新斯的明、誘導(dǎo)排尿、小便通暢率,組間數(shù)據(jù)無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);6對(duì)比兩組患者術(shù)后當(dāng)日排尿評(píng)分狀況,治療組(1.1±0.9)分,對(duì)照組(3.6±1.2)分,組間數(shù)據(jù)有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明聯(lián)合手術(shù)方式比單純性手術(shù)治療,術(shù)后患者可更好的排尿;7對(duì)比兩組術(shù)后出血率,治療組14%比對(duì)照組36%低,組間數(shù)據(jù)有統(tǒng)計(jì)學(xué)意義(P0.05);8用X2檢驗(yàn)兩組患者術(shù)后指診積分狀況,P=0.528,0.05,因此,此兩組患者術(shù)后指診積分不具有統(tǒng)計(jì)學(xué)意義(P0.05);9用X2檢驗(yàn)兩組患者術(shù)后失禁功能評(píng)分狀況,P=0.823,0.05,因此,此兩組患者術(shù)后失禁功能評(píng)分不具有統(tǒng)計(jì)學(xué)意義(P0.05);10將治療組治療療效94%和對(duì)照組78%進(jìn)行對(duì)比,前者更高,經(jīng)統(tǒng)計(jì)學(xué)學(xué)分析后得知,組間數(shù)據(jù)有統(tǒng)計(jì)學(xué)意義(P0.05),表明肛瘺瘺管剔除術(shù)和對(duì)口引流保留皮橋術(shù)聯(lián)合應(yīng)用在單純性肛瘺疾病治療中具有優(yōu)勢(shì)性;11術(shù)后隨訪(fǎng)期間兩組均無(wú)復(fù)發(fā)病例,其復(fù)發(fā)率均為0%,組間數(shù)據(jù)無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:肛瘺瘺管剔除聯(lián)合對(duì)口引流保留皮橋術(shù)是一種安全有效的治療單純性肛瘺疾病的新術(shù)式。在肛瘺疾病得到有效治療的同時(shí),還能改善患者的生活質(zhì)量,提高患者的滿(mǎn)意度。其臨床推廣應(yīng)用價(jià)值較高。
[Abstract]:Objective: To compare the fistula drainage combined with eliminating skin bridge reservation operation and fistula resection in the clinical effect of treatment of anal fistula, fistula drainage combined with eliminating skin bridge reservation surgery in the clinical treatment of simple anal fistula advantage. Methods: from May 2015 to May 2016 in Qian'an City People's hospital received surgical treatment and met the study the conditions of anal fistula were randomly divided into treatment group and control group, treatment group 50 cases, surgery for anal fistula from United counterpart drainage retention skin bridge operation; the control group of 50 cases, surgery for anal fistula resection; patients were followed up for 6 months, observe and record the two groups of patients pain, urination, bleeding, hospitalization time, wound healing time, postoperative wound infection, anal function, curative effect; followed up 6 months after discharge, understand the recurrence of anal fistula, the discussion of this 鐮旂┒涓墍閲囩敤娌葷枟鏂瑰紡鐨勫畨鍏ㄦ，

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