一次性根治术治疗肛周脓肿的临床疗效分析

A comparative study on clinical efficacy of one-time radical resection and simple open drainage in treatment of perianal abscess

摘要:

目的 探讨一次性根治术与单纯切开引流术治疗肛周脓肿的临床疗效。方法 选取2017 年1 月— 2017 年12 月浙江省绍兴第二医院肛肠外科收治的116 例肛周脓肿患者作为研究对象。根据随机数字表法分 为研究组和对照组，每组58 例。研究组采用一次性根治术治疗，对照组采用单纯切开引流术治疗，比较两组 临床疗效、住院时间、术后复发率、术后并发症、IL-1α、IL-6、TNF-α、IL-4、IL-10 蛋白和mRNA 表 达水平。结果 与对照组比较，研究组有效率和显效率高，住院时间短，复发率和并发症发生率低（P <0.05）； 术后第1 和7 天，研究组IL-1α、IL-6 及TNF-α 蛋白水平低于对照组（P <0.05）；术后第7 天研究组IL- 1α、IL-6 及TNF-α mRNA 水平低于对照组（P <0.05），而IL-4 和IL-10 mRNA 水平高于对照组（P <0.05）。 结论 一次性肛周脓肿根治术可以减少患者的住院时间，降低术后复发率及并发症发生率，总有效率较高，值 得临床应用与推广。

Abstract:

Objective To explore the clinical effect of one-off radical resection and simple open drainage in the treatment of perianal abscess. Methods Totally 116 patients with perianal abscess admitted to Shaoxing Second Hospital between January and December 2017 were selected as study subjects. According to the random number table method, they were divided into an observation group and a control group, with 58 cases in each group. The patients of the observation group were treated with one-time radical surgery, while those of the control group were treated with open drainage. The clinical effect, hospitalization time, postoperative recurrence rate, postoperative complications, and mRNA and protein levels of IL-1α, IL-6, TNF-α, IL-4 and IL-10 were compared between the two groups. Results Compared to the control group, the effective rate was higher, the hospitalization time was shorter, the postoperative recurrence rate and the incidences of postoperative complications were lower in the observation group, and the differences were statistically significant (P < 0.05). On the 1st and 7th days after surgery, IL-1α, IL-6 and TNF-α protein levels in the observation group were significantly lower than those in the control group (P < 0.05). On the 7th day after surgery, IL-1α, IL-6 and TNF-α mRNA levels in the observation group were significantly lower than those in the control group (P < 0.05), while IL-4 and IL-10 mRNA levels in the observation group were significantly higher than those in the control group (P < 0.05). Conclusions Compared with the simple incision drainage, one-time radical resection can shorten the patient’s hospital stay, lower the cost of treatment, reduce the postoperative recurrence rate and the incidences of postoperative complications, and has higher total effective rate; it is worthy of clinical application and promotion.