Application Research On Treatment Of High Anal Fistula With First Solid Then Dotted Thread-ligating Therapy Based On Principle Of Internal High Pressure

Objective:To compare the clinical effect of treating high anal fistula with first solid then dotted thread-ligating therapy based on principle of internal high pressure and traditional solid thread-ligating therapy,and strive to choose a curative effect,better protection of anal sphincter function of the wire hanging operation for the treatment of high anal fistula.Methods:A total of 72 patients with high anal fistula who were admitted to the national anorectal center of the Nanjing hospital of traditional Chinese medicine from September 2016 to December 2018 and met the diagnostic criteria with surgical indications were selected.According to the random number table method.The patients were randomly divided into the experimental group and the control group,including 36 cases in the experimental group.In the control group,36 cases were treated by.Experimental group were treated by first solid then dotted thread-ligating therapy based on principle of internal high pressure.The control group were treat by traditional solid thread-ligating therapy.Postoperative wound healing time,length of stay,pain score([using visual analogue(VAS)score],anal incontinence score(Wexner score),anal sphincter function(anorectal pressure measurement),and anal digital diagnostic score were compared between the two groups in three to six month.Results:(1)A11 patients were followed up for 3-6 months,and there was no statistical difference in the effective rate,recurrence rate between the two groups(P>0.05).(2)Wound secretion comparison:there was no significant difference in wound secretion scores between the two groups on day 1,4 and 7 after surgery(P>0.05).(3)Comparison of wound healing time between the two groups:the average wound healing time of patients in the experimental group was(28.61±4.49)days.Patients in the control group averaged(34.4714.12)days,,indicating a statistical difference(P<0.01).(4)Postoperative pain score comparison:on the first day after surgery,the P value was 0.635,indicating no statistical significance(P>0.05).The comparison of pain scores on the 7th day after surgery was statistically significant(P<0.01)and statistically significant on the 14th day(P<0.05).(5)Comparison of anorectal pressure measurement:postoperative ARP,AMCP and sphincter function length(HPZ)in the experimental group were all higher than those in the control group,with statistically significant differences(P<0.01).(6)Anal digital diagnosis score comparison:1 month,3 months and 6 months after surgery,the anal digital diagnosis score of the experimental group was significantly lower than that of the control group,with statistical difference.(7)No keyhole anal deformity was found in both groups.Conclusion:The treatment of high anal fistula with the method of first solid then dotted thread-ligating therapy based on the principle of internal pressure is basically consistent with the traditional method of hanging line in terms of effective rate,recurrence rate and improving postoperative wound secretion.However,it has some advantages in alleviating postoperative pain,shorrtening wound healing time and protecting anal sphincter function.Is based on the principle of high pressure of the mouth inside after the first real virtual hang line method in assuring effect of traditional cutting hang line method,on the basis of cut due to the more traditional hanging line method(real hang)to protect the part of the organization,in the anus sonourethrography.membranous closure protection function,relieve local pain,wound healing,etc is superior to the traditional incision hangs line method(hung),has certain clinical value.