三间隙引流术在高位肛周脓肿中的应用效果分析OA
Clinical Effect of Three-Space Drainage in Treatment of High Perianal Abscess
目的:探讨三间隙引流术治疗高位肛周脓肿的临床效果.方法:选取2024年1月至2025年1月我科收治的110例高位肛周脓肿患者,按1∶1随机分为对照组和试验组,每组55例.对照组采用常规切开引流术治疗,试验组采用三间隙引流术治疗.比较2组术后首次排便时及第7天疼痛视觉模拟量表(VAS)评分,术前及术后第7天疼痛相关血液指标[5-羟色胺(5-HT)、去甲肾上腺素(NE)]与炎症指标[白细胞介素(IL)-1β、IL-6、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、激活素A(ACTA)]水平,住院时间、创面愈合时间,术前一天及术后第7天、1个月时的肛门Wexner评分,以及术后随访情况.结果:试验组术后首次排便时及第7天肛门VAS评分均低于对照组,P<0.05.试验组住院时间及创面愈合时间均短于对照组,P<0.05.2组术前一天及术后1个月时肛门Wexner评分比较差异均无统计学意义,P>0.05;术后第7天,试验组肛门Wexner评分低于对照组,P<0.05.术后第7天,试验组疼痛相关血液指标(5-HT、NE)及炎症指标(IL-1β、IL-6、CRP、TNF-α、ACTA)水平均低于对照组,P<0.05.试验组肛门失禁、肛瘘形成、复发率均低于对照组,P<0.05.结论:三间隙引流术可有效促进高位肛周脓肿创面愈合,缩短住院时间,减轻术后疼痛,并有助于控制局部炎症反应,且促进肛门功能恢复,安全性较好.
Objective To investigate the clinical effect of three-space drainage in the treatment of high peri-anal abscess.Methods A total of 110 patients with high perianal abscess admitted to our department from January 2024 to January 2025 were randomly divided into a control group and an experimental group at a ratio of 1:1,with 55 cases in each group.The control group was treated with conventional incision and drainage,while the experimental group was treated with three-space drainage.The Visual Analogue Scale(VAS)scores for pain during the first postoperative defecation and on the 7th day after surgery were compared between the two groups.The levels of pain-related blood indicators[5-hydroxytryptamine(5-HT),norepinephrine(NE)]and inflammatory indicators[interleukin(IL)-1β,IL-6,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),activin A(ACTA)]were measured before surgery and on the 7th day after surgery,and the data were compared between the two groups.Additionally,the length of hospital stay,wound healing time,Wexner anal function scores one day before surgery as well as on the 7th day and 1 month after surgery,and postoperative follow-up outcomes were compared between the two groups.Results The anal VAS scores of the experimental group during the first postoperative defecation and on the 7th day after surgery were signifi-cantly lower than those of the control group(P<0.05).The length of hospital stay and wound healing time of the experimental group were shorter than those of the control group(P<0.05).There were no statistically sig-nificant differences in Wexner anal function scores between the two groups one day before surgery and 1 month after surgery(P>0.05).However,on the 7th day after surgery,the Wexner anal function score of the experi-mental group was lower than that of the control group(P<0.05).On the 7th day after surgery,the levels of pain-related blood indicators(5-HT,NE)and inflammatory indicators(IL-1β,IL-6,CRP,TNF-α,ACTA)in the experimental group were all lower than those in the control group(P<0.05).The incidence rates of anal incontinence,anal fistula formation and recurrence in the experimental group were lower than those in the con-trol group(P<0.05).Conclusion Three-space drainage can effectively promote wound healing in patients with high perianal abscess,shorten the length of hospital stay,alleviate postoperative pain and help control local inflammatory response.It also promotes the recovery of anal function and has good safety.
曹丹;袁东辉;张英
永煤集团总医院肛肠科(河南 永城 476600)永煤集团总医院肛肠科(河南 永城 476600)永煤集团总医院肛肠科(河南 永城 476600)
高位肛周脓肿三间隙引流术切开引流术疗效
High perianal abscessThree-space drainageIncision and drainageClinical efficacy
《中国肛肠病杂志》 2026 (2)
36-38,3
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