| BackgroundThe sacral tail pilonidal sinuspoints to fistula or cystin the sacral tail containing hair.European and American countries with a high incidence of this disease, but is not very common in our country.In recent years, our country incidence of casesis on the rise.The characteristics of the diseaseare the misdiagnosis rate and high relapse rate.The diagnosis of the ilonidal sinus is difficult, due to the lack of enough understanding of the disease.The sinus infection may be formed at the end of the sacral, one or a few sinus, sometimes extended to crissum abscess of infection, symptoms and signs similar to anal fistula and crissum abscess.The diagnosis can be the tail of acute or chronic abscess fistula with secretions, local acute inflammation.Secondary fistula is much above the primary sinus crossing the cranial side, often slightly to one side.Antrum and anal is not the same.Sinus in hair are a typical manifestation of the disease, but not the only standard of diagnosis.Flexible hollow probe is my invention, currently approved two national patents, its main structure is flexible hollow circular tube and can have scale, head end for oval head shape needles, the end can be connected in the syringe needle and the probe has strong flexibility, and the surface is smooth, so it is not easy to go every false way, can fistula bending, antrum, cavity, the influence of such irregular shape along the fistula, fistula, cavity, can clear the fistula, antrum, cavity, and it is hollow structure, needle and syringe can be connected to stain or contrast agents through probe into hollow, tracer effect can more easily determine the location of the lesions and scope.So it can have precise surgery, less wounds, less operation time, less bleeding, small vice injury, patients recover quickly, shorten the wound healing time, and the operation cure rate is high.Studies about the flexible application of hollow probe are:scientific and technological achievements, research topics and main awards:"flexible hollow probe in the application research of diagnosis and treatment of complex anal fistula" in 1996 in hebei province scientific and technological achievements, baoding science and technology progress prize in 1997." The application research of diagnosis and treatment of abscess with flexible hollow probe around the anus rectum the " in 2012, approved by the Beijing daxing district science and technology commission project, Chinese academy of traditional Chinese medicine, the gate level hospitals in the southern district about the topic, research recommend daxing district of Beijing science and technology progress prize in 2015,in 2013 Beijing worker outstanding technical innovation excellent awardThis research is the national patent technology "flexible hollow probe" application in the diagnosis and treatment of sacral tail pilonidal sinus, and comparing research, key technology research, improve the effect of sacral tail pilonidal sinus in the diagnosis and treatment.ObjectiveThe flexible hollow probe was applied to the diagnosis and treatment of sacral tail pilonidal sinus, to further improve the diagnosis and treatment of the disease, and further explore the creativity of flexible hollow probe, practicality, novelty, embody the value of patent technology in clinical medicine.Further explore the etiology, pathology foundation, characteristics of related research of the sacral tail pilonidal sinus.methods110 cases during 2011.9-2016.3all are by Guang an men Hospital in Chinese academy of traditional Chinese medicine with sacral tail pilonidal sinus.Retrospective analysis summary, according to adopt flexible hollow probe diagnostic and not by the probe diagnostic applications (including ordinary probe and with or without probe support with experience in diagnosis and treatment) is divided into research group and the control group.The research group adopts flexible hollow probe and joint dyeing, imaging diagnosis and treatment;the control group using common methods diagnosis and treatment (including the application of ordinary probe and with or without probe support with experience in diagnosis and treatment). We use professional statistical software SPSS16.0 for analysis.Study two groups patients of age, sex, weight, number of sinus, first sufferings incidence, recurrence, the length of the fistula, antrum containing hair such as foreign body condition, etc., the total cure rate of the 2 groups, operation cure rate, operation time, period of treatment, pain score, intraoperative lesion resection after wound closure rate, degree of postoperative pain score, sinus passage contains the foreign body, such as hair, health economics and other important indexes were analyzedCombined with the literature research is analyzed and summarizedResultsThe onset of 2 groups of patients age, sex, weight, number of sinus, first the sufferings incidence, recurrence, the length of the fistula, antrum contains hair such as foreign body condition, and so on and so forth after statistical analysis, there was no statistically significant difference (P> 0.05,2 groups are comparable.Through the study of these indicators also can see that the disease occurs in males, the heavier weight, obesity, constitution of the patients.In this study the disease onset age distribution is the youngest person 16 years of age, age at most 50, average age 22.8±4.3,16 and 20 years of age (30%),21-30 years of age (50%),31-40 years of age group (14.5%),41 years of age group (5.4%) or higher, as you can see in this study the sacral tail pilonidal sinus onset age is with 16-30 people most, accounted for 80%, due to youth activities, the sebaceous glands secrete exuberant.From the onset of the disease, gender and weight distribution can see the dominant male patients, accounted for 75.5%, while women less, still can see the heavy weight, obese patients is more, most patients are overweight.Found in the research of the disease about antrum mouth is some have, some don’t, some have more than one, this study cases without outside who account for 42.7% of these cases are mostly associated with local uplift, skin redness, incipient acute infection in clinic, more external port with 1 (22.7%), outside the port with 2 or more (multiple) accounted for 34.5%, with the port is always more burst of infection, not definitie treatment of patients in time, these cases associated with fistula formation, some fistula winding, and has the branch.Some antrum length is 2.5 cm, some antrum length is up to 40 cm, an average of 7.4±4.5 cm, most of the cases between 3 cm to 12 cm.Confirmed by surgery inside antrum hair accounted for 72%, with a few cases with ossification of fibrous tissue, accounted for 1.8%, all cases were granulation tissue hyperplasia.Pathological results is accompanied by fibrous connective tissue hyperplasia in cuticle, some mixed epidermal tissue, hair, accompanied by more inflammatory cells infiltration, and granulation tissue formation.lt also to some extent reflects the 2 relationships between pathogenesis of the disease.Through the study found that there is no difference between the total cure rate of two groups, all can finally curedBut in the operation, an operation cure rate and treatment time, intraoperative lesion resection after wound closure rate, degree of postoperative pain score, average and good patient’s hospitalization cost of such confinement have significant difference on the key indicators, both by statistical treatment, P< 0.01, the points above are as follows:Operation time:shortest team for 15 minutes, the longest 2 hours, an average of 25±6 minutes.Control the shortest 20 minutes, the longest three hours, an average of 55±10 minutes.The control group reduced 30 minutes, reduced by 54.5%.Treatment:the team the shortest 12 days, the longest 50 days, an average of 22±3 days;Control the shortest 13 days,60 days, the longest average 37 plus or minus five days;Team is shorter than the control group,15 days shorten by 40.5%.An operation cure rate:the team operation,58 patients with an operation cure 57 cases,1 case of patients with obesity, fat liquefaction hemorrhage, postoperative wound infection dehiscence, cured by reoperation after debridement, the case in accordance with the requirements of this study is not an operation cure, so the team an operation cure rate 98.1%;Control group 52 cases, a surgery to cure the 44 cases, the rest 8 patients postoperative recurrence after 3 months, of which 7 cases patient surgery to cure again,1 case of patients with postoperative recurrence after 4 months, after thorough debridement curedAn operation control group cure rate 84.6%.Two groups total cure rate was 100%, no difference, but the research than the control group on an operation cure rate by 13.5%,16.0% higher.Intraoperative lesion resection after wound closure rate:intraoperative team mode 58 cases, lesions after removal of the wound closed 38 cases, the wound of 20 patients with open wound closure rate was 65.5%;The control group of 52 cases, lesions after removal of the wound closed 22 cases, cut open 29 cases, the wound closure rate was 42.3%.The wound closure rate the indicators, the team was 23.2% higher than the control group,54.8% higher. Pain degree of postoperative pain score:the research score 2.32±1.31 (on average];Control group pain score [on average) 4.53±1.52.Research group is tower than the control group on average pain score of 2.21, down 48.8%.Average such confinement:13.5±3.2 days team;18.7±5.5 in the control group.Group than the control group on average 5.2 days less of such confinement, less by 27.8%.Patient’s hospitalization cost:the team 1.02±02700 yuan;1.38±0.46 in the control group.Group than the control group in reducing hospitalization expenses are 3600 yuan, fell by 26.1%.Conclusion1. Sacral tail pilonidal sinus is with the low incidence, there are some difficulties, but make a diagnosis and treatment for refractory disease, the disease rate is higher is its characteristic, the reason is the preoperative intraoperative can not accurately grasp the fistula contorts and scope, therefore accurate grasp the fistula contorts and scope is the key to the correct treatment of the disease and curing foundation.2. Flexible hollow probe approved two national patents, has obvious creativity, practicality, novelty, applied to the diagnosis and treatment of complex anal fistulaaround the anus rectum and abscess in, high clinical application value, and peer recognition, a certain level awards.Flexible hollow probe was applied to the study of diagnosis and treatment of sacral tail pilonidal sinus increased significantly in the diagnosis and treatment effect, and the operation time, an operation cure rate, period of treatment, patients’pain and other important indicators has obvious advantages, once again proved that the probe clinical practical value, but also demonstrate the superiority of national patent technology, theory and technological innovation at the same time, more embodies the concept of "precision medical treatment", and realistic significance.3. So far, we haven’t seen a sacral tail pilonidal sinus application reports of diagnosis and treatment with hollow flexible probe combined with the domestic and foreign counterparts.Researchers report that it’s not hard to infer, so the study is higher innovative.In conclusion, this study will provide the sacral tail pilonidal sinus fistula, antrum of theory and the practice basis.It can be to imagine, after a good promotion, the findings are widely used in clinical time is not too long with broad prospects. It also further evidence that the scientific and technological achievement has certain social significance. |
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