摘要
目的:探讨超声清创治疗联合生物反馈治疗对肛周脓肿术后创面愈合及括约肌功能恢复的影响。方法:选取2016年9月至2017年10月行肛周脓肿术患者90例作为研究对象,将其随机分为常规治疗组、超声清创组和超声清创联合生物反馈治疗组3组,每组30例。常规治疗组术后给予生理盐水清创治疗,超声清创组术后给予超声清创仪清创治疗,联合组在超声清创基础上给予生物反馈治疗,对比分析3组患者治疗后创面疼痛程度评分、分泌物评分、肉芽形态评分、周围组织水肿评分、腐肉脱落时间、上皮出现时间、创面愈合时间、首次细菌清除率及肛肠动力学变化。结果:联合治疗组临床总有效率高于超声组、常规组,差异有统计学意义(P<0.05)。超声清创组和联合治疗组患者腐肉脱落时间、上皮出现时间、创面愈合时间均明显短于常规治疗组,其中联合治疗组创面愈合时间明显短于超声清创组(P<0.05);术后14d,超声清创组和联合治疗组患者创面疼痛评分、分泌物评分、肉芽形态评分、组织水肿评分均明显低于常规治疗组(P<0.05)。联合治疗组、超声组首次细菌清除率明显高于常规组(P<0.05)。联合治疗组患者治疗后直肠静息压明显低于其它两组,最大收缩压、排便窘迫阈值、最大耐受阈值明显高于其它两组(P<0.05)。结论:超声清创与生物反馈联合治疗能够有效缩短肛周脓肿术患者术后创面愈合时间,改善术后肛管直肠动力学。
Objective： To investigate the effect of ultrasound debridement therapy combined with biofeedback therapy on postoperative wound healing and sphincter function recovery of perianal abscess. Methods： 90 cases of patients underwent perianal abscess in the hospital from September 2016 to October 2017 were enrolled in this study and were randomly divided into routine treatment group,ultrasonic debridement group and ultrasonic debridement combined with biofeedback therapy group. Patients in the conventional treatment group were treated with saline debridemen,patients in Ultrasonic debridement group were given ultrasound debridement treatment,and patients in the combined group were given biofeedback on the basis of ultrasound debridement. The wound healing rate,the wound healing time,the first bacterial clearance rate and the anorectal dynamics were compared between the three groups after treatment. Results： The total effective rate in the combined treatment group was higher than that in the ultrasound group and the conventional group（P 0.05）. The carrion off time,epithelial time,wound healing time of patients in ultrasonic debridement group and combined treatment group were significantly shorter than the conventional treatment group（P 0.05）. inwhich the wound healing time of the combined treatment group was significantly shorter than that of the ultrasound debridement group（P 0.05）. After 14 days,the scores of wound pain,secretory score,granulation score and tissue edema were significantly lower in the patients with ultrasound debridement and combination therapy than those in the conventional treatment group（P 0.05）. The first bacterial clearance rates in patients with ultrasound debridement group and combination therapy group were significantly higher than that in routine treatment group（P 0. 05）; The first time bacterial clearance rate in the combined treatment group was significantly higher than that in the ultrasound group and the conventional group（P 0.05）. The rectal resting pressure in the combined treatment group was significantly lower than that of the other two groups,and the maximal systolic pressure,defecation and distress threshold and the maximum tolerance threshold were significantly higher than those of the other two groups（P 0.05）. Conclusion： Ultrasonic debridement combined with biofeedback can effectively shorten the healing time of postoperative wound in patients with perianal abscess and improve postoperative anal rectal dynamics.
作者
贾国璞
刘晓丽
陈建华
JIA Guopu;LIU Xiaoli(The Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)
出处
《河北医学》
CAS
2018年第8期1346-1351,共6页
Hebei Medicine
基金
河北省承德市科学技术研究与发展计划项目
(编号:201701A038)
关键词
肛周脓肿
超声清创
生物反馈
创面愈合
肛肠功能
Perianal abscess
Uhrasound debridement
Biofeedback
wound healing
Anoreetal function
