知识与财富的链接
目的：研究 TROPIS 改良挂线法治疗高位肛瘘的临床疗效。方法：将 72 例高位肛瘘患者随机分为治疗组(采用TROPIS 改良挂线法治疗,n=36)和对照组(采用切开挂线术治疗,n=36),比较两组的疼痛指数、创面面积(术后当天、术后 14 d、术后 1 个月)、肛管静息压(ARP)、肛管最大收缩压(AMCP)、大便失禁 Wexner 评分、创面愈合时间、住院时间、住院费用、术后并发症及复发情况。结果：两组患者的住院时间、治愈率、肛管静息压、肛管最大收缩压比较差异无统计学意义(P >0.05)。治疗组的创面愈合时间为[60(50,79)]d,短于对照组的[110(96, 129)]d;治疗组住院费用为(11 134.53±3 394.88)元,少于对照组的(14 225.92±6 535.61)元;治疗组使用镇痛泵组的疼痛指数为[1.0(0.0, 1.0)]分,低于对照组的[2.0(1.0,2.0)]分;治疗组术后当天、术后 14 d、术后 1 个月的创面面积分别为(10.58±5.62)cm2、(6.59±4.24)cm2、(3.5...
Objective To study the clinical effect of TROPIS modified suture method in the treatment of high anal fistula. Methods Seventy-two patients with high anal fistula were randomly divided into experimental group (TROPIS modified suture method, n=36) and control group (incision suture method, n=36). The pain index, wound area (postoperative day, postoperative 14 days, postoperative 1 month), anal canal resting pressure (ARP), anal canal maximum systolic pressure (AMCP), Wexner score of fecal incontinence, wound healing time, length of stay, hospitalization cost, postoperative complications and recurrence were compared between the two groups. Results There were no significant differences in hospital stay, cure rate, anal canal resting pressure and anal canal maximum systolic pressure between two groups (P > 0.05). The wound healing time in the treatment group [60 (50,79)]d was shorter than that in the control group [110 (96, 129)]d. The hospitalization cost of the treatment group was (11 134.53±3 394.88) yuan, which was less than that of the control group (14 225.92±6 535.61) yuan. The pain index in the treatment group was [1.0 (0.0, 1.0)], lower than that in the control group [2.0 (1.0, 2.0)]. The wound area of the treatment group was (10.58±5.62)cm2, (6.59±4.24)cm2 and (3.56±3.03)cm2 on the day after surgery, 14 days after surgery and 1 month after surgery respectively, which were all smaller than those in the control group (28.05±5.76)cm2, (21.59±4.49)cm2 and (13.48±3.63)cm2. With the extension of treatment time, the reduction of wound area in the treatment group was larger. The score of fecal incontinence 3 months after operation in the treatment group was [0.0 (0.0,1.0)], which was lower than that in the control group [2.0 (0.0, 2.0)]. The probability of postoperative complications of air leakage and fluid leakage was 2.8%(1/35) less than that of control group 16.7% (6/30) (all P < 0.05). Conclusion Compared with incision and transfixion, TROPIS modified suture method for the treatment of high anal fistula has a higher cure rate, less damage to the anal pericardial function, safety and effectiveness, less complications, economic benefits, and it is worthy of clinical promotion.