目的 探讨一次性根治术联合新型敷料与传统手术方案对青年患者肛周脓肿的疗效对比。方法 选取武警湖北总队医院2023-01至2024-08收治的肛周脓肿患者50例,随机分为观察组（一次性根治术+新型敷料）和对照组（传统切开引流术+凡士林纱布）,每组25例。比较两组创面愈合时间、换药次数、疼痛评分（VAS）及肛瘘发生率。结果 观察组和对照组平均愈合时间为[（13.36±6.26）d vs.（21.56±9.21）d,P<0.05],换药次数[（7.96±2.42）次 vs.（15.40±6.33）次,P<0.05],术后1周换药疼痛评分[（4.64±1.19）vs.（6.00±1.22）,P<0.05],术后6个月肛瘘发生率8% vs. 36%（P<0.01）,差异均有统计学意义。结论 联合疗法可显著缩短创面愈合时间,减少术后换药次数,减轻疼痛,降低肛瘘发生率,尤其适合青年群体快速康复需求。
Abstract
Objective To compare the therapeutic effects of one-time radical surgery combined with new dressings and traditional surgical methods in treating perianal abscess in young patients. Methods Fifty patients with perianal abscess admitted to Hubei Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2023 to August 2024 were selected and randomly divided into an observation group （one-time radical surgery+new dressing） and a control group （traditional incision and drainage + vaseline gauze）,with 25 patients in each group. The wound healing time,number of dressing changes,pain score （assessed by VAS）, and the incidence of anal fistula were compared between the two groups. Results The average healing time of the observation group and the control group were [（13.36±6.26）d vs.（21.56±9.21）d,P<0.05], the number of dressing changes was (7.96±2.42) times compared to （15.40±6.33） times （P<0.05）, the pain score at 1 week after surgery were [（4.64±1.19）vs.（6.00±1.22）,P<0.05] in the observation group and the control group, and the incidence of anal fistula at 6 months after surgery were 8% vs 36% （P<0.01）, all of which showed statistically significant differences. Conclusions Combination therapy can significantly shorten wound healing time,reduce dressing changes, alleviate pain, and lower the incidence of anal fistula, especially suitable for the rapid recovery needs of young people.
关键词
肛周脓肿 /
一次性根治术 /
新型敷料 /
疗效 /
青年男性
Key words
perianal abscess /
one-time radical surgery /
new dressing /
therapeutic effect /
young male
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Lohsiriwat V,Yodying H,Lohsiriwat D.Incidence and factors influencing the development of fistula-in-ano after incision and drainage of perianal abscesses[J].J Med AssocThai, 2010, 93(1):61-65.
[2] Sahnan K,Askari A,Adegbola SO,et al. Natural history of anorectal sepsis[J].Br J Surg, 2017, 104(13): 1857-1865.
[3] El-Tawil A M. Mechanism of non-specific-fistula-in-ano:hormonal aspects-Review[J]. Pathophysiology, 2012,19(1):55-59.
[4] Seow-En I,Ngu J.Routine operative swab cultures and post-operative antibiotic use for uncomplicated perianal abscesses are unnecessary[J].ANZ J Surg,2017,87(5):356-359.
[5] 魏秀芝,殷骅,胡晶晶,等.腔内双平面超声联合超声造影在诊断肛周脓肿的应用价值[J].中国超声医学杂志, 2021,37(9):1053-1056.
[6] Sørensen K M, Möller S, Qvist N.Needle aspiration treatment vs incision of acute simple perianal abscess: randomized controlled study[J]. Int J Colorectal Dis,2021, 36(3):581-588.
[7] 黎耀东,李武军,吴涛,等.改良药纱联合微波在肛周脓肿术后治疗中的作用[J].临床和试验医学杂志,2014,13(22):1877-1879.
[8] 陈巧红,蓝丽玲.藻酸盐银离子敷料与凡士林纱布敷料对慢性感染伤口愈合效果的影响比较[J].吉林医学, 2022,43(4):1120-1122.
[9] 刘晓新,刘进炼,刘姚,等.红外线疗法联合银离子抗菌敷料在骨科创伤后压力性损伤患者中的应用[J].齐鲁护理杂志, 2022,28(8):98-101.
[10] 陈爱琼,林永洁,等.软聚硅酮泡沫吸收敷料联合常规护理对慢性创面愈合的作用研究[J].现代医学与健康研究, 2022,6(9):128-131.
[11] 陈慧超,马珂珂,宫丹丹,等.一次性切开根治术治疗肛周脓肿的Meta分析[J/OL].中华结直肠疾病电子杂志, 2021,10(4):385-391.
[12] 徐玉超,孙英刚,谭京忠,等.肛周脓肿手术预后不良的危险因素分析[J].武警医学,2025, 36(4):301-309.
[13] 张玮玮,张新炎,王靖.高频浅表与腔内探头联合应用对肛周脓肿手术的指导价值[J].武警医学,2014,25(6):602-604.
[14] 毛捷鸿,张磊.一次性肛周脓肿根治术治疗肛周脓肿的临床研究[J].中国现代医生,2020,58(6):45-47.
[15] 韩兴兵,范雷涛,孙源.超声清创仪联合藻酸盐敷料换药对肛周脓肿术后创面愈合的疗效研究[J].中国医学装备,2022,19(5):120-124.
[16] 庞文静,洪瑞青.银离子敷料在肿瘤患者PICC置管术后穿刺点固定中的应用[J].齐鲁护理杂志,2020,26(5):100-102.
[17] 周凌寒,康丽萍,康良琦,等.银离子敷料联合负压引流治疗感染性伤口的系统评价[J].中华护理教育,2021,18(11):1032-1039.
[18] 李芳家,温贤秀,闵丽华,等.软聚硅酮泡沫敷料在神经外科糖尿病患者伤口修复中的应用[J].实用医院临床杂志,2021,18(3):34-36.
[19] 游艾佳,李文婕,周俊丽,等.六种敷料对全髋、膝关节置换后伤口安全性的系统评价[J].中国组织工程研究,2023,27(3):486-492.
[20] 曹国丽. 主动关联结合多模式镇痛在肛周脓肿病人中的应用[J].循证护理,2023,9(24):4535-4539.
[21] 宋霞,刘桂荣,方秋娜,等.新型敷料结合心理护理干预对慢性伤口患者的影响[J].心理月刊,2022,4(17):167-169.
[22] 张泽仪,胡涛.观察切开引流术治疗肛周脓肿的护理方法和效果[J].中国继续医学教育,2020,12(7):197-198.
[23] 姚齐,沈曦,葛引观.新型敷料在门诊伤口护理中的应用[J].中国乡村医药,2022,29(2):55-56.
[24] 唐志敏,唐丽琴,曾羽佳,等.可用于伤口感染检测的新型敷料的研究进展[J].东华大学学报(自然科学版),2021,47(4):12-18.
[25] 林雪花. 精细化伤口处理结合新型敷料对3-4期压力性损伤患者创口愈合效果的影响[J].中西医结合护理(中英文),2021,7(12):88-90.
PDF(2175 KB)
