中藥熏洗輔助分段掛線引流治療高位肛周膿腫的臨床療效

畢憲坤

摘要：目的? 探討中藥熏洗輔助分段掛線引流治療高位肛周膿腫的臨床療效。方法? 選取2016年2月～2018年8月我院收治的高位肛周膿腫患者123例，隨機分為對照組（n=61）和觀察組（n=62）。對照組予以常規(guī)分段掛線引流治療，觀察組予以中藥熏洗輔助分段掛線引流治療，比較兩組臨床療效、創(chuàng)口愈合時間、術(shù)后并發(fā)癥及復(fù)發(fā)情況。結(jié)果? 觀察組總有效率為98.39%，高于對照組的88.52%，差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組創(chuàng)面愈合時間為（14.02±2.12）d，短于對照組的（23.69±3.26）d，差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組術(shù)后創(chuàng)口滲液、肛瘺發(fā)生率及復(fù)發(fā)率分別為3.23%、1.61%、1.61%，均低于對照組的19.67%、11.48%、13.11%，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論? 中藥熏洗輔助分段掛線引流治療高位肛周膿腫療效顯著，可促進創(chuàng)口愈合，降低術(shù)后并發(fā)癥及復(fù)發(fā)風(fēng)險，安全性較高。

關(guān)鍵詞：高位肛周膿腫;中藥熏洗;分段掛線引流

中圖分類號：R657.1? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻標識碼：A? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2019.15.051

文章編號：1006-1959（2019）15-0154-03

Abstract：Objective? To investigate the clinical efficacy of traditional Chinese medicine fumigation and washing combined with segmental drainage for the treatment of high perianal abscess.Methods? A total of 123 patients with high perianal abscess admitted to our hospital from February 2016 to August 2018 were randomly divided into control group （n=61） and observation group （n=62）. The control group was treated with routine segmental drainage and the observation group was treated with traditional Chinese medicine fumigation and washing. The clinical efficacy， wound healing time， postoperative complications and recurrence were compared between the two groups.Results? The total effective rate of the observation group was 98.39%， which was higher than that of the control group 88.52%，the difference was statistically significant （P<0.05）. The wound healing time of the observation group was（14.02±2.12）d， which was shorter than that of the control group（23.69±3.26）d，the difference was statistically significant （P<0.05）. The incidence of exudate and anal fistula， recurrence rate was? 3.23%， 1.61%， 1.61% in the observation group， which were lower than those in the control group 19.67%、11.48%、13.11%， the difference was statistically significant（P<0.05）.Conclusion? Traditional Chinese medicine fumigation and washing assisted segmental drainage for the treatment of high perianal abscess is effective， which can promote wound healing， reduce the risk of postoperative complications and recurrence， and has higher safety.

Key words：High perianal abscess;Traditional Chinese medicine fumigation;Segmental hanging line drainage

肛周膿腫（perianal abscess）是發(fā)生于肛腺管入括約肌間隙的一種細菌感染性疾病，膿腫切開引流是治療本病的主要手段，但術(shù)后膿腫極易復(fù)發(fā)，且術(shù)后肛瘺幾率較高，需再次手術(shù)。分段掛線引流手術(shù)雖可在一定程度上降低術(shù)后肛瘺風(fēng)險，降低二次手術(shù)率，但術(shù)后長時間肛周水腫及創(chuàng)口滲液等并發(fā)癥嚴重影響愈合。近年來，中藥熏洗療法逐漸應(yīng)用于肛周膿腫治療，有研究認為[1]，中藥熏洗坐浴將藥物結(jié)合熱效應(yīng)，在促進血運同時達到消腫止痛、促進創(chuàng)面愈合目的。本文主要探討中藥熏洗輔助分段掛線引流治療高位肛周膿腫的臨床療效，現(xiàn)報道如下。

1資料與方法

1.1一般資料? 選取2016年2月～2018年8月佳木斯市中醫(yī)院收治的高位肛周膿腫患者123例，按照隨機數(shù)字表法分為對照組和觀察組。對照組61例，其中男39例，女22例;年齡22～62歲，平均年齡（38.26±6.02）歲;病程6～19 d，平均病程（9.12±2.48）d;疾病類型：坐骨直腸間隙膿腫28例，骨盆直腸間隙膿腫21例，直腸后間隙膿腫12例。……