A Clinical Randomized Controlled Trial And Mechanism Study On The Treatment Of Perianal Abscess By Medical Thread Double Seton

Objective:This project aims to systematically and objectively evaluate the safety and efficacy of " Medical thread double seton " in sciatic rectal abscess for glandular infection,and to explore the mechanism of Xue xiang powder line in promoting postoperative wound healing.Methods:A total of 54 cases were collected from the Department of Proctology,Affiliated Hospital of Jiangxi University of Chinese Medicine,who met the inclusion criteria for inpatient surgical treatment of ischiorectal space abscess with gland-derived infection from January 2022 to December 2022.According to the random number table method,the patients were divided into 3 groups,and 18 cases were obtained in the Medical thread double seton group,Simple incision and drainage group and one-time radical surgery group,the Medical thread double seton group was operated by Medical thread double seton,the Simple incision and drainage group was operated by simple incision and drainage,and the one-time radical surgery group was treated with perianal abscess one-time radical surgery.Before treatment,the age,sex,course of disease and BMI of patients were analyzed and compared.The recurrence rate of perianal abscess,the rate of fistula formation,wound healing time and hospital stay,function,wound score,VAS score,and the concentration expression of VEGF and bFGF in wound tissues before treatment and 14 days after treatment were observed and compared between the three groups,and the adverse reactions of patients during the entire treatment period were observed,and long-term follow-up was carried out in the three groups.Outcome:1.There was no significant difference in the baseline data(age,sex,course of disease,BMI)between the three groups(P>0.05),which was com Parable;2.Comparison of wound scores: on the first day after surgery,wound exudate and There were no significant differences in edema and granulation tissue growth(P>0.05),the scores of the Medical thread double seton group were better than those of Simple incision and drainage group and control<group 2 on the 7th postoperative day(P<0.05),and there was no significant difference in granulation tissue growth between the three groups(P>0.05),and On the 14th postoperative day,the ooze in the Medical thread double seton group was better than the other two groups,and the difference was statistically significant(P<0.05);the edema in the Medical thread double seton group was significantly different from that in the Simple incision and drainage group(P<0.05);the granulation tissue growth in the Medical thread double seton group was better than that in the incision and Simple incision and drainage group and one-time radical surgery group(P<0.05);3.Comparison of VAS scores: on the first day after surgery,the difference was not statistically significant(P>0.05),and on the 7th and 14th days after surgery,the Medical thread double seton group was better than the other two groups,The difference was statistically significant at 14 days postoperatively(P<0.05);4.Comparison of VEGF and bFGF contents in tissues: there was no significant difference in VEGF and bFGF content between the three groups on the day of surgery(P>0.05);the contents of VEGF and bFGF in the three groups were significantly higher than before(P<0.05),and the contents of VEGF and bFGF in the Medical thread double seton group were more significant than those in the Simple incision and drainage group and one-time radical surgery group(P<0.05);5.Comparison of function: within the group,the resting pressure of the canal,the maximum systolic blood pressure of the canal and the Wexner score were improved three months after surgery;Compared between the groups,there was no significant difference between the three groups of resting pressure and Wexner score at 1 month after surgery,and the maximum systolic blood pressure Medical thread double seton group > Simple incision and drainage group > one-time radical surgery group,The difference was statistically significant(P<0.05),and 3 months after surgery,there were significant differences between anorectal pressure Medical thread double seton group and Simple incision and drainage group compared with one-time radical surgery group(P<0.05),and there was no significant difference between the Medical thread double seton group and Simple incision and drainage group,There was no significant difference between the Wexner score Medical thread double seton group and Simple incision and drainage group(P>0.05),and the difference with one-time radical surgery group was statistically significant(P<0.05);6.Comparison of recurrence rate of perianal abscess: the difference was not statistically significant(P>0.05);comparison of fistula formation rate:the Medical thread double seton group(5.6%)and the one-time radical surgery group(5.6%)were significantly lower than the Simple incision and drainage group(38.9%),and the difference was statistically significant(P<0.05);7.Comparison of hospital stay: the difference was not statistically significant(P>0.05);the wound healing time was compared: the Medical thread double seton group was lower than that of the Simple incision and drainage group and the one-time radical surgery group,and the difference was statistically significant(P<0.05);8.Overall efficacy comparison: the difference between the Medical thread double seton group(94.4%)and the Simple incision and drainage group(61.1%)was statistically significant(P<0.05),and the difference from the one-time radical surgery group(94.4%)was not statistically significant(P>0.05);9.Safety analysis: In this study,the three groups of patients did not have adverse reactions and other discomforts during and after surgery,and there were no abnormal performance in safety indicators.Conclusion: Compared with traditional surgery,the sciatic rectal abscess of glandular infection by Medical thread double seton has the advantages of lower abscess recurrence rate,less fistula formation rate,protection of function,and reduction of postoperative pain compared with traditional surgery,and the Xue xiang powder used in the drug line can promote wound repair and reduce the healing time by regulating the expression of VEGF and bFGF in wound tissue.