| ObjectiveAnal fistula is one of the most common anorectal diseases.Surgery is the only cure.It is the consensus of doctors and patients to seek a surgical method that can protect anal function and accelerate wound healing.By comparing the treatment group(one-stage orthotopic Shaped Skin Grafting plus fistulectomy)with the control group(fistulectomy)in the treatment of Intersphincter anal fistula(Damp invasion of lower energizer),to observe the clinical efficacy and surgical safety,to provide a scientific basis for clinical application.MethodsA prospective study was conducted on 86 patients with Intersphincter anal fistula(Damp invasion of lower energizer)admitted to the first affiliated hospital of GuangZhou university of TCM.They were randomly divided into control group and treatment group,43 patients in each group.Two patients in the control group and one patient in the treatment group were excluded because of meeting the withdrawal conditions.The hospital stay,operation time,wound healing days,anal function,postoperative infection,wound bleeding,postoperative pain and recurrence rate were observed and recorded.The follow-up period was from 4 months to 1 year.ResultComparing hospitalization time:the average hospitalization days in the control group were 7.10(+3.46)days,and the average hospitalization days in the control group were 5.95(+2.54)days,with no significant difference(t=1.726,P>0.05).Comparing operation time:The average duration of operation in the control group was 40.73(+17.84)minutes,while that in the control group was 55.12(+20.82)minutes.The difference was statistically significant(t=-3.377,P<0.05).Comparing wound healing days:control group was 26.10+ 3.25 days,control group was 14.43+1.15 days.The difference was significant(t=21.675,P<0.05).Comparing anal function:38 cases in the control group had normal anal function,3 cases had partial anal incontinence,41 cases in the treatment group had normal anal function and 1 case had partial incontinence.There was no significant difference(x2=1.102,P>0.05).Comparing the wound infection after operation:39 cases in the control group had no infection,2 cases had mild infection,41 cases in the treatment group had no infection and 1 case had mild infection.There was no significant difference(x2=0.371,P>0.05).Comparing the degree of wound bleeding:11 patients in the control group had degree I bleeding,27 patients had degree II bleeding and 3 patients had degree III bleeding.The treatment group had 24 cases of degree I and 18 cases of degree II,with significant difference(z=-4.909,P<0.05).Comparing the pain scores after operation:The average pain scores of the control group on the day of operation,one week after operation and two weeks after operation were 5.10(+2.63),3.29(+1.52)and 2.22(+1.12).The scores of the treatment group were 3.21(+2.18),2.02(+0.87)and 0.57(+0.63),respectively,with significant difference(P<0.05).Comparing the recurrence rate:The follow-up period ranged from 4 months to 1 year,and the recurrence rate was 0%.There was no significant difference(P>0.05).ConclusionThe treatment group increased the operation time,but did not increase the operation risk.There was no significant difference in hospitalization days,anal function and wound infection between the two groups.Compared with the control group,the treatment group had certain advantages in shortening the healing time of the wound,alleviating the pain of the wound after operation and reducing the bleeding of the wound.one-stage orthotopic Shaped Skin Grafting plus fistulectomy has the advantages of promoting wound healing,reducing wound pain,reducing wound bleeding,high cure rate,safety and effectiveness. |
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