康复新液纱条联合挂线术对肛周脓肿切口愈合及感染创面愈合的影响
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摘要
目的比较引流术、挂线术及康复新液纱条联合挂线术对肛周脓肿切口愈合及感染创面愈合的疗效。方法 75例肛周脓肿患者随机分为引流组、挂线组、纱条联合挂线组各25例,分别采取切开引流术、切开挂线术、康复新液纱条联合切开挂线术治疗。分别于术后2、7、14d评估各组患者疼痛程度,并于术后7、14、21d测定创面缩小率;记录各组术后切口开始愈合时间、感染创面愈合时间以及腐肉脱落时间,记录各组治疗后住院时间并统计复发率。结果术后2、7、14d各组疼痛程度比较差异有统计学意义(P <0. 01),其中术后2、7、14d引流组疼痛程度评分明显高于挂线组、纱条联合挂线组,且术后7、14d挂线组明显高于纱条联合挂线组(P <0. 05)。术后7、14、21d各组创面缩小率比较差异有统计学意义(P <0. 01)。各时间点纱条联合挂线组创面缩小率均明显大于引流组与挂线组,而挂线组均明显高于引流组(P <0. 05)。纱条联合挂线组切口开始愈合、感染创面愈合、腐肉脱落及住院时间均较引流组、挂线组明显缩短,挂线组亦较引流组缩短(P <0. 05);纱条联合挂线组术后复发率为4. 00%,明显低于引流组(28. 00%)及挂线组(12. 00%),挂线组亦明显低于引流组(P <0. 05)。结论康复新液纱条联合挂线术可有效缩短肛周脓肿切口愈合及感染创面愈合时间并降低复发率,其疗效较引流术及单纯挂线术更佳。
Objective To compare the effects of drainage,thread-drawing,and Kangfuxinye Yarn( 康复新液纱条) combined with thread-drawing on incision healing of perianal abscess and healing of infected wound. Methods A total of 75 cases of perianal abscess were randomly divided into drainage group,thread-drawing group and yarn combined with thread-drawing group,with 25 cases in each group. Three groups were respectively treated by drainage,thread drawing and Kangfuxinye Yarn combined with thread-drawing. The pain degree of each group was evaluated 2,7 and 14 days after operation,and the wound area reduction rate was measured 7,14 and 21 days after operation. The healing time of wound incision,the healing time of infected wound and the time of carrion shedding were recorded. The hospitalization time after treatment and the recurrence rate of each group were counted. Results The difference of pain degree of each group 2,7 and 14 days after operation was statistically significant( P < 0. 01),among which the pain level score of drainage group was significantly higher than that of the thread-drawing group and yarn combined with thread-drawing group 2,7 and 14 days after operation,and the score of thread-drawing group was significantly higher than that of yarn combined with thread-drawing group 7 and 14 days after operation( P < 0. 05).The wound area reduction rate of all groups was significantly different 7,14 and 21 days after operation( P < 0. 01).The wound area reduction rate of yarn combined with thread-drawing group was significantly larger than that of drainage group and thread-drawing group at each time point,and the thread-drawing group was superior to the drainage group( P < 0. 05). The healing time of wound incision,the healing time of infected wound,the time of carrion shedding and the hospitalization time of the yarn combined with thread-drawing group were significantly shorter than those of the drainage group and thread-drawing group,and the thread-drawing group was superior to the drainage group( P <0. 05). The recurrence rate of the yarn combined with thread-drawing group was 4. 00%,which was significantly lower than the drainage group( 28. 00%) and the thread-drawing group( 12. 00%). The thread-drawing group was also superior to the drainage group( P < 0. 05). Conclusion Kangfuxinye Yarn combined with thread-drawing can effectively shorten the healing of incision and infected wound of perianal abscess and reduce recurrence rate,its clinical effects are better than drainage and thread-drawing alone.
Objective To compare the effects of drainage,thread-drawing,and Kangfuxinye Yarn( 康复新液纱条) combined with thread-drawing on incision healing of perianal abscess and healing of infected wound. Methods A total of 75 cases of perianal abscess were randomly divided into drainage group,thread-drawing group and yarn combined with thread-drawing group,with 25 cases in each group. Three groups were respectively treated by drainage,thread drawing and Kangfuxinye Yarn combined with thread-drawing. The pain degree of each group was evaluated 2,7 and 14 days after operation,and the wound area reduction rate was measured 7,14 and 21 days after operation. The healing time of wound incision,the healing time of infected wound and the time of carrion shedding were recorded. The hospitalization time after treatment and the recurrence rate of each group were counted. Results The difference of pain degree of each group 2,7 and 14 days after operation was statistically significant( P < 0. 01),among which the pain level score of drainage group was significantly higher than that of the thread-drawing group and yarn combined with thread-drawing group 2,7 and 14 days after operation,and the score of thread-drawing group was significantly higher than that of yarn combined with thread-drawing group 7 and 14 days after operation( P < 0. 05).The wound area reduction rate of all groups was significantly different 7,14 and 21 days after operation( P < 0. 01).The wound area reduction rate of yarn combined with thread-drawing group was significantly larger than that of drainage group and thread-drawing group at each time point,and the thread-drawing group was superior to the drainage group( P < 0. 05). The healing time of wound incision,the healing time of infected wound,the time of carrion shedding and the hospitalization time of the yarn combined with thread-drawing group were significantly shorter than those of the drainage group and thread-drawing group,and the thread-drawing group was superior to the drainage group( P <0. 05). The recurrence rate of the yarn combined with thread-drawing group was 4. 00%,which was significantly lower than the drainage group( 28. 00%) and the thread-drawing group( 12. 00%). The thread-drawing group was also superior to the drainage group( P < 0. 05). Conclusion Kangfuxinye Yarn combined with thread-drawing can effectively shorten the healing of incision and infected wound of perianal abscess and reduce recurrence rate,its clinical effects are better than drainage and thread-drawing alone.
引文
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[11]JEONG WS,CHOI SY,JEONG EH,et al. Perianal Abscess and proctitis by klebsiella pneumoniae[J]. Intest Res,2015,13(1):85-89.
[12]孙刚,顾汝军,刘冬良,等.切开引流挂线术与单纯切开引流术治疗肛周脓肿的疗效比较[J].中国实用外科杂志,2012,32(s1):254-255.
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[14]RENCUZOGULLARI A. Retention of vacuum-assisted closure device sponge leading to a perianal abscess and fistula[J]. Int Wound J,2015,12(6):739-740.
[15]任玲,邢承忠,凌光烈,等.切开挂线术与切开引流术治疗肛周脓肿的疗效对比[J].局解手术学杂志,2017,26(5):340-343.
[16]张启新,刘菲,徐延芹,等.抗菌药物与切开挂线术治疗对肛肠疾病肛周菌群影响的研究[J].中华医院感染学杂志,2015,25(13):2984-2986.
[17]贾春燕,杜欣,孙爱华,等.氦氖激光和吹氧联合康复新液治疗肛周感染的临床观察[J].中国药房,2013,24(40):3767-3769.
[18]史成和,孟开,王春勇,等.康复新液治疗消化道溃疡随机对照试验的系统评价[J].华西医学,2012,27(8):1121-1125.
[19]林海玲,李国坚,吴继周.磷酸铝凝胶磷酸铝凝胶、康复新液对溶血卵磷脂相关反流性食管炎模型大鼠食管组鼠食管组织学和IL-8、PGE2的影响[J].南方医科大学学报,2015,35(4):573-577.
[20]刘童婷,黄秀深,陈瑾,等.康复新液对大鼠乙酸烧灼型胃溃疡模型胃黏膜修复机制的研究[J].时珍国医国药,2012,23(12):3028-3030.
[21]梁桂香.外用溃疡散和康复新液治疗复发性阿弗他溃疡的临床疗效[J].武汉大学学报(医学版),2015,36(4):643-645.
[2]GHAHRAMANI L,MINAIE MR,ARASTEH P,et al. Antibiotic therapy for prevention of fistula in-ano after incision and drainage of simple perianal abscess:A randomized single blind clinical trial[J]. Hooshanginejad Z,2017,162(5):1017-1025.
[3]QIN X,DING B,LI Y. Herbal multicomponent extracts enhance wound healing after incision of perianal abscess and in a rat model of infected wounds[J]. Australas J Dermatol,2018,59(1):76-78.
[4]CHANG H,KUO MC,TANG TC,et al. Clinical features and recurrence pattern of perianal abscess in patients with acute myeloid leukemia[J]. Acta Haematol,2017,138(1):10-13.
[5]NALDAN ME,ARI MA,GUVENDI B,et al. An infected primary extrapelvic hydatid cyst presenting as perianal abscess[J]. Surgery,2017,162(4):961-962.
[6]SEEMANN NM,KING SK,ELKADRI A,et al. The operative management of children with complex perianal Crohn's disease[J]. J Pediatr Surg,2016,51(12):1993-1997.
[7]HASAN RM. A study assessing postoperative Corrugate Rubber drain of perianal abscess[J]. Ann Med Surg(Lond),2016,11(9):42-46.
[8]PANG LM,KONG FB,WANG XT,et al. Efficacy of vacuum sealing drainage after incision of perianal abscess:preliminary experience[J]. Am Surg,2015,81(11):E379-E382.
[9]肖振球,吴和木,田建利,等.肛肠疾病的诊疗及微创技术[M].上海:第二军医大学出版社,2012:159.
[10]QIN X,DING B,LI Y,et al. Herbal multicomponent extracts enhance wound healing after incision of perianal abscess and in a rat model of infected wounds[J]. Australas J Dermatol,2018,59(1):76-78.
[11]JEONG WS,CHOI SY,JEONG EH,et al. Perianal Abscess and proctitis by klebsiella pneumoniae[J]. Intest Res,2015,13(1):85-89.
[12]孙刚,顾汝军,刘冬良,等.切开引流挂线术与单纯切开引流术治疗肛周脓肿的疗效比较[J].中国实用外科杂志,2012,32(s1):254-255.
[13]PERERA AP,HOWELL AM,SODERGREN MH,et al.A pilot randomised controlled trial evaluating postoperative packing of the perianal abscess[J]. Langenbecks Arch Surg,2015,400(2):267-271.
[14]RENCUZOGULLARI A. Retention of vacuum-assisted closure device sponge leading to a perianal abscess and fistula[J]. Int Wound J,2015,12(6):739-740.
[15]任玲,邢承忠,凌光烈,等.切开挂线术与切开引流术治疗肛周脓肿的疗效对比[J].局解手术学杂志,2017,26(5):340-343.
[16]张启新,刘菲,徐延芹,等.抗菌药物与切开挂线术治疗对肛肠疾病肛周菌群影响的研究[J].中华医院感染学杂志,2015,25(13):2984-2986.
[17]贾春燕,杜欣,孙爱华,等.氦氖激光和吹氧联合康复新液治疗肛周感染的临床观察[J].中国药房,2013,24(40):3767-3769.
[18]史成和,孟开,王春勇,等.康复新液治疗消化道溃疡随机对照试验的系统评价[J].华西医学,2012,27(8):1121-1125.
[19]林海玲,李国坚,吴继周.磷酸铝凝胶磷酸铝凝胶、康复新液对溶血卵磷脂相关反流性食管炎模型大鼠食管组鼠食管组织学和IL-8、PGE2的影响[J].南方医科大学学报,2015,35(4):573-577.
[20]刘童婷,黄秀深,陈瑾,等.康复新液对大鼠乙酸烧灼型胃溃疡模型胃黏膜修复机制的研究[J].时珍国医国药,2012,23(12):3028-3030.
[21]梁桂香.外用溃疡散和康复新液治疗复发性阿弗他溃疡的临床疗效[J].武汉大学学报(医学版),2015,36(4):643-645.