Clinical Application Research Of Self-Locking Quantitative Line Quantitative Cutting Seton In High Anal Fistula

Objective:Using theself-lockingquantitative line as unified seton line material, we do research on the application in treating patients with high anal fistula through different two groups tight line programme.We attempt to find the best quantitative tight line programme to ensure that the function of anal sphincter isn’t obviously damaged as well as curative effect. All of these can reduce to pain both physically and mentally by the tight line method, improve the quality of patient’s living standards and shorten wound healing time.Methods:From March 2015 to December 2015,32 patients of high anal fistula who were treated in Seven Ward of Anorectal Branch at the hospital of the third affiliated hospital of Nanjing University of T.C.Mwere included in the present prospective study, and randomly divided into the test group (using "stepped type" line tight programme:tissue circumferences≥ 8cm, each time line tight about 3cm; tissue circumferences between 5cm and 8cm,each time line tight about 2cm; tissue circumferences<5cm, each time line tight about 1cm,16 cases) and control group (using "Little times but frequently" line tight programme:line tight 3 days once,each time line tight 0.5cm,16 cases).Compare the anal function, the pain of the wound and the condition of tight line in the two groups after operation and follow up for 3 months.All results were quantified to scores according to the scoring criteria.With statistic analysis, the difference in the function of anal, the degree of the anal pain, the times of tighting line and off-line, the time of healing and so on can be study.Results:(1) After three months, total effective rate of two groups are respectively 100% and 93.8%.Control group has a cases invalid while the test group are all effective. There was no statistically difference between the two groups(P>0.05);(2) Wexner score of anal function and digital rectal examination of anal function were no statistically difference between the two groups (P>0.05);(3)At the first/fifth/seventh day after operation, there was no statistically difference in the degree of the anal pain between the two groups(P>0.05), however, there was a significant difference in the degree of the anal pain between the two groups at the first/third/day after tighting line (P<0.05).But there was no statistically difference between the average value of tighting line back and forth(P>0.05); (4)There was no statistically difference in tissue circumferences between the two groups before tight line (P>0.05);however, there was statistically difference in the times of fighting line and off-line between the two groups (P<0.05);(5)There was no statistically differencein the proportion of male and female, the average age, the total average time of beginningtight line(P>0.05); (6) There was no statistically difference in the time of healing between the two groups(P>0.05).Conclusion:This research showed that it is convenient to use the self-locking quantitative lineas quantitative tight line. There was no obviously difference in the overall effect of quantitative tight line programme between the two groups. However, they have different features: "Stepped type" tight line programme, can reduce times of line tighting and shortened line-off time, which reduce to pain for patients both physically and mentally by the tight line method; "Little times but frequently" tight line programme had relatively lower pain at the 1st and the 3rd day, particularly suited for the elderly and weak patients or patients with poor tolerance to pain.