| 刘慧峰,姜国丹,李南,等.改良括约肌间瘘管结扎术对经括约肌肛瘘病人肠道微生态、并发症、括约肌功能影响[J].安徽医药,2025,29(2):344-348. |
| 改良括约肌间瘘管结扎术对经括约肌肛瘘病人肠道微生态、并发症、括约肌功能影响 |
| Effect of lift-plug surgery on intestinal microbiota, complications, and sphincter function in patients with transanal sphincter fistula |
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| DOI：10.3969/j.issn.1009-6469.2025.02.027 |
| 中文关键词: 直肠瘘 括约肌间瘘管结扎术 肠道微生态 神经源性炎症因子 并发症 |
| 英文关键词: Rectal fistula Lift-plug procedure Intestinal microecology Neurogenic inflammatory factors Complications |
| 基金项目:北京市卫生和计划生育委员会课题( 2018-1-2032) |
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| 中文摘要: |
| 目的探究改良括约肌间瘘管结扎术( Lift-plug)在经括约肌肛瘘( TSAF)病人治疗中的应用优势。方法回顾性收集 2020年 3月至 2022年 3月首都医科大学附属北京潞河医院 110例 TSAF病人临床资料，根据手术方法分为两组，传统组 55例行 Lift，Lift-plug组 55例行 Lift-plug术。比较两组围术期指标、临床疗效、并发症、复发率及神经源性炎症因子［P物质( SP)、神经生长因子( NGF)、前列腺素 E2(PGE2)］、肠道微生态［D-乳酸、二胺氧化酶( DAO)］、肛门括约肌功能(肛门功能指数评分、 Wexner尿失禁评分)。结果 Lift-plug组手术时间［( 20.22±3.34)min比( 23.89±4.11)min］、创面愈合时间［( 25.50±3.38)d比 |
| 英文摘要: |
| Objective To explore the application advantages of ligation of the intersphincteric fistula tract plus bioprosthetic anal fis-tula plug (Lift-plug) in the treatment of transsphincter anal fistula (TSAF).Methods The clinical data of 110 patients with TSAF whowere treated in Beijing Luhe Hospital Affiliated to Capital Medical University from March 2020 to March 2022 were retrospectively col-lected, and they were assigned into two groups according to the surgical methods. The conventional surgery group (n=55) underwent Lift surgery, while the Lift-plug group (n=55) underwent Lift-plug surgery. A comparison was made between the two groups of perioperativeindexes, clinical efficacy, complications, recurrence rate, neurogenic inflammatory factors [substance P (SP), nerve growth factor (NGF),prostaglandin E2 (PGE2)], intestinal microecology [D-lactic acid, diamine oxidase (DAO)], and anal sphincter function (anal function in-dex score, Wexner urinary incontinence score).Results The operation time [(20.22±3.34) min vs. (23.89±4.11) min], wound healing time [(25.50±3.38) d vs. (30.31±4.56) d] and hospital stay [(5.88±0.82) d vs. (6.42±1.03) d] of the Lift-plug group were shorter than those of the conventional surgery group, and the VAS score of the Lift-plug group was lower than that of the conventional surgery group one day after surgery [(2.41±0.35) scores vs. (3.02±0.42) scores] (P<0.05). The levels of SP, NGF and PGE2 in the Lift-plug group were lower than those in the conventional surgery group one day after surgery (P<0.05). There were no significant differences in D-lactic acid and plasma DAO levels between the two groups 1 day and 3 days after surgery (P>0.05). The anal function index and Wexner urinary incontinence score in the Lift-plug group were lower than those in the conventional surgery group one month and three months after sur-gery (P<0.05). Three months after surgery, the total effective rate of the Lift-plug group was higher than that of the conventional surgery group (P<0.05). There were no significant differences in the incidence and recurrence of complications 3 months after operation be-tween the two groups (P>0.05).Conclusion Lift-plug surgery for TSAF patients can optimize surgery, reduce neurogenic inflammatoryresponse, alleviate early pain, improve sphincter function, and enhance clinical efficacy, which achieves great safety. |
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