摘要
[目的]观察挂线治疗坐骨直肠间隙脓肿疗效。[方法]使用随机平行对照方法,将60例门诊患者按就诊顺序编号方法简单随机分为两组。对照组30例取膀胱截石位,常规消超声定位脓腔中心点切开脓腔,排出脓液,分离脓腔纤维隔,清除坏死组织,双氧水和生理盐水冲洗后填塞无痛生肌散凡士林纱条引流,塔形敷料压迫,丁字带外固定,无处理内口动作。治疗组30例挂线:取膀胱截石位,彩超、指诊等确定脓肿范围,以脓腔中心位置在臀部垂直投影为形成肛瘘外口位置,索罗门定律寻找内口,即经过肛门两侧坐骨结节画一横线,外口在横线前方,距肛门5cm内,则内口在齿线上与外口相对应;外口在距肛门5cm外或在横线后方,则内口多在肛管后部齿线处;术者左手食指放入肛内协助,右手持球头探针沿切口轻轻探入,在相应齿线附近探查原发感染内口;以食指伸入肛内作引导,另一手持探针经脓腔寻找内口;内口已溃破,探针可顺利引出;内口寻找困难,在针指间最薄弱处穿出,引入橡皮筋将切口与肛门间皮肤切开,橡皮筋松紧适度后结扎,同时结扎原发内口两侧肛腺组织,填塞无痛生肌散凡士林纱条引流,塔形敷料压迫,丁字带外固定。治疗1次为1疗程。观测临床症状、不良反应。治疗1疗程(1次),判定疗效。[结果]治疗组治愈20例,好转3例,无效7例,总有效率76.67%;对照组治愈5例,好转6例,无效19例,总有效率36.67%。[结论]挂线治疗坐骨直肠间隙脓肿,疗效满意,无严重不良反应,值得推广。
[Objective] Observe the hanging line sciatic abscess rectum gap curative effect. [Methods] Using random parallel control method, 60 cases of clinic patients in clinic order numbering method is simple and randomly divided into two groups. Control group 30 cases take bladder stone cutting, the conventional ultrasonic positioning center of vomica cut the vomica, discharge pus, separation of pus cavity fiber, removal of necrotic tissue, hydrogen peroxide and saline flushing after filling the painless article spread vaseline gauze drainage, the production of tower dressing oppression, with external fixation, no mouth movements in processing. Treatment group 30 cases of hanging line： bladder stone cutting, colour to exceed, dre and determine the scope of the abscess, position at the center of the pus cavity in the hip position outside the vertical projection for the formation of anal fistula mouth, Solomon＇s law to find inside the mouth, draw a horizontal line, namely through the anus ischial tuberosity on both sides outside in front of a horizontal line, 5 cm from the anus, mouth on the tooth line within and outside the mouth corresponding; Outside the mouth from the 5 cm outside anus or behind the horizontal lines, more than in the anal canal within the mouth teeth at the back of the line; Within the performer puts his left index finger into the anus to assist, the fight hand ball head probe into gently along the incision, near the corresponding tooth line detection in primary infection; With the index finger into the anus for guidance, the other a hand-held probe by the pus cavity mouth inside looking for; The inlet has been broken, probe can successfully lead; Finding difficulties in mouth, in the needle between refers to the most vulnerable place, the introduction of a rubber band between the incision and anal skin incision, rubber band elastic moderate after ligation, ligation in primary mouth anal gland tissue on both sides at the same time, stuffing painless article spread vaseline gauze drainage, the production of tower dressing oppression, t with external fixation. 1 to 1 course of treatment. Observation of clinical symptomsand adverse reactions. Treatment as a course （1）, to determine efficacy. [Result] the treatment group treated 20 cases, improvement in 3 cases, 7 had no effect, the total effective rate was 76.67%; and 6 cases of control group cure in 5 cases, improved 19 cases, total effective rate was 36.67%. Hang line. [Conclusion] treatment of sciatic abscess rectum gap, curative effect is satisfied, no serious adverse reactions, worthy of promotion.
出处
《实用中医内科杂志》
2017年第4期11-13,共3页
Journal of Practical Traditional Chinese Internal Medicine
基金
辽宁省自然基金(No:2013020207)
辽宁省教育厅资助项目(No:L2013371)
辽宁省名老中医工作室建设项目~~
关键词
坐骨直肠间隙脓肿
挂线
索罗门定律
膀胱截石位
隐窝腺学说
中医药治疗
随机平行对照研究
sciatic abscess rectum gap
the line
solomon＇s law
bladder cut stone
crypt gland theory
traditional Chinese medicine treatment
random parallel control study
