ABSTRACT
Objective To explore the difference of the curative effect between incision-thread-drawing procedure and traditional incision drainage in the treatment of perianal abscess.Methods A total of 150 patients diagnosed with perianal abscess and treated at the first time from June 2015 to June 2016 in our department were selected as the research object in this experiment,who were divided into the observation group(75 cases) and control group(75 cases) according to the surgical method.Patients in the observation group were performed with incision-thread-drawing procedure,while the control group were treated by traditional incision drainage.The overall treatment effect,operation time,postoperative recovery time,hospital stay,hospital costs,wound healing time and postoperative complications between the two groups were observed and compared.Results The difference of the overall treatment effects between two groups were not statistically significant(P>0.05).The operation time,the postoperative recovery time,the hospitalization time and the cost,the time of wound healing of observation group were significantly better than the ones of the control group,the differences were statistically significant(P<0.05).The recurrence rates of anal fistula,abscess and other complications in patients of observation group were significantly lower than the ones of control group.The differences were statistically significant(P<0.05).Conclusion Compared with traditional incision drainage,the incision-thread-drawing procedure is more effective with less complications and lower recurrence rate,which should be the first choice for the treatment of perianal abscess.
ABSTRACT
Objective To explore influence of antibiotics and Jiuyi Dan combined with incision-thread-drawing procedure on perianal abscess patients' level of activin A (ACTA) and C-reactive protein (CRP).Methods120 cases of perianal abscess patients in our hospital during March 2015 to December 2016 Coloproctology were selected, they were divided into the experiment group and the control group by random number method.All of patients were taken incision-thread-drawing procedure.Then the experimental group were given nine one antibiotics and Jiuyi Dan, the control group were given antibiotics.The cure rate, 6months after the recurrence rate, average healing time of the wound, and wound edema rate of two groups were observed.Levels of ACTA and CRP expression levels of two groups of patients before and after operation were analyzed.ResultsPatients in the experimental group cure rate was 96.7% higher than that of the control group (P<0.05), the recurrence rate of patients in the experimental group than in the control group, the difference was not statistically significant;the patients in the experimental group the average healing time was (20.67±3.22) d shorter than the average healing time of patients in the control group (29.48±3.15) d, patients in the experimental group wound edema rate of 5% was significantly lower than in the control group 20% (P<0.05);3D ACTA, the expression level of CRP was significantly higher than the preoperative 7 d levels after operation in the two groups (P<0.05);after 7d, the expression level of the two groups of patients with ACTA and CRP were significantly lower than the preoperative level of expression of 7d (P<0.05), experimental group levels of ACTA were significantly lower than the control group, the difference was statistically significant (P<0.05);postoperative 14d patients, ACTA levels of two groups were significantly lower than the levels before operation (P<0.05).ConclusionPerianal abscess can be treated effectively and patients levels of Acta and CRP were obviously dereased by Jiuyi Dan combined with incision-thread-drawing procedure combined, postoperative inflammatory reaction could be importantly alleviated, it was worth clinical promotion.
ABSTRACT
Objective To systematically investigate the clinical efficiency and safety of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Methods Searched PubMed,The Cochrane Library,CNKI,WanFang Data,and VIP from inception to May 2016,to collect randomized controlled trials of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Search term included ligation of inter sphincteric fistula tract,fistula,incision-thread-drawing procedure,randomized controlled trial.The literatures were screened according to inclusive criteria,data were extracted and the quality of included studies was evaluated,and then meta-analysis was performed using RevMan 5.2 soft ware.A total of 5 randomized controlled trials including 305 patients were included.Results The results of meta-analysis showed that compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract had a significant difference in amount of bleeding during surgery (MD =-18.30,95％ CI:-19.91 ～-16.69,P ＜ 0.000 01),the duration of pain (MD =-4.38,95％ CI:-4.69 ～-4.08,P ＜ 0.000 01),healing time (MD =-10.28,95％ CI:-15.71 ～-4.86,P =0.0002),hospital stay (MD =-7.44,95％CI:-10.87～-4.02,P＜0.000 1),recurrence rate (OR=0.31,95％CI:0.10～0.91,P=0.03).There was no significant difference in Operation time (MD =-5.83,95 ％ CI:-7.64 ～-4.02,P ＜ 0.000 01),effective percentage (OR =4.35,95％ CI:0.89 ～ 21.32,P =0.07) between both groups.Conclusion Compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract shows significant advantage in cure rate,postoperative healing time,reducing post-operation pain,anal function protection and recurrence rate.