| 姚飞,凌怡庭,李步卓,李森娟,郭红梅,胡毕文,陈振伟,邱敏,曹晨曦.经括约肌间切开术（TROPIS）+改良Parks松挂线术治疗复杂性肛瘘的临床效果观察[J].浙江中西医结合杂志,2026,36(2): |
| 经括约肌间切开术（TROPIS）+改良Parks松挂线术治疗复杂性肛瘘的临床效果观察 |
| Observation on the clinical effect of transanal opening of intersphincteric space (TROPIS)+loose seton technique(LST) in the treatment of complex anal fistula |
| 投稿时间：2024-11-05 修订日期：2025-03-19 |
| DOI： |
| 中文关键词: 经括约肌间切开术、改良Parks松挂线术、复杂性肛瘘 |
| 英文关键词:transanal opening of intersphincteric space (TROPIS) loose seton technique(LST) Complex anal fistula. |
| 基金项目:嘉兴市科技计划自主研发项目（2023AD31028）、嘉兴市科技计划自主研发项目（2023AD11016） |
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| 中文摘要: |
| 摘要 目的：观察经括约肌间切开术（TROPIS）+改良Parks松挂线术治疗复杂性肛瘘的临床效果。方法：将2023年03月01日至2024年07月31日在嘉兴市第二医院住院诊断为复杂性肛瘘的90例患者，随机分为试验组（采用经括约肌间切开术（TROPIS）+改良Parks松挂线术，n=45）和对照组（采用保留皮桥的隧道式肛瘘切除术，n=45），比较两组患者术后疼痛评分、完全愈合时间、术后创面炎症反应程度及直肠测压结果。结果：试验组患者术后第1、3、7天的疼痛评分均低于对照组，创面完全愈合时间较对照组短，术后前3天每天的创面渗出液中TNF-α、IL-8、IL-6含量均较对照组低，肛管收缩压、主动收缩压均优于对照组，差异有统计学意义（P＜0.05）。两组患者肛管静息压、直肠顺应性比较，差异均无统计学意义（P＞0.05）。结论：与保留皮桥的隧道式肛瘘切除术相比，经括约肌间切开术（TROPIS）+改良Parks松挂线术治疗复杂性肛瘘，能减轻患者术后疼痛及术后创面炎症反应程度，缩短创面愈合时间，更好地保护肛门功能，临床效果好，值得推广应用。 |
| 英文摘要: |
| Abstract
Objective: To observe the clinical effect of transanal opening of intersphincteric space (TROPIS) +loose seton technique(LST) in the treatment of complex anal fistula. Methods: Ninety patients diagnosed with complex anal fistula and hospitalized in Jiaxing Second Hospital from March 1, 2023 to July 31, 2024 were randomly divided into an experimental group (treated with transanal opening of intersphincteric space (TROPIS) + loose seton technique(LST), n = 45) and a control group (treated with tunnel anal fistulectomy with preserved skin bridge, n = 45). The postoperative pain score, complete healing time, degree of postoperative wound inflammation, and rectal manometry results were compared between the two groups. Results: The pain scores of patients in the experimental group on the 1st, 3rd, and 7th day after surgery were lower than those in the control group. The complete wound healing time was shorter than that in the control group. The contents of TNF-α, IL-8, and IL-6 in the wound exudate every day in the first three days after surgery were lower than those in the control group. The anal systolic blood pressure and active systolic blood pressure were better than those in the control group. The differences were statistically significant (P < 0.05). There was no statistically significant difference in anal canal rest pressure and rectal compliance between the two groups (P > 0.05). Conclusion: Compared with tunnel anal fistulectomy which preserved skin bridge,transanal opening of intersphincteric space (TROPIS) + loose seton technique(LST) in the treatment of complex anal fistula can reduce postoperative pain and the degree of postoperative wound inflammation, shorten wound healing time, and better protect anal function. It has good clinical effects and is worthy of popularization and application. |
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