肛瘘挂线术后肛门功能的回顾性队列研究

肛瘘挂线术后肛门功能的回顾性队列研究摘要：

目的：本文旨在探讨肛瘘挂线术后肛门功能的恢复情况及影响因素。

方法：我们对2014年1月至2018年12月在我院行肛瘘挂线术的患者进行了回顾性队列研究，共纳入了130例研究对象。观察指标包括排便功能、肛门括约肌压力、肛门运动、切断括约肌肌肉反射、排便时间及肠道运动等。

结果：术后肛门括约肌压力、肛门运动、切断括约肌肌肉反射及肠道运动功能早期均有不同程度的损伤及障碍，但是，通过术后的运动和康复训练，这些损伤不良影响得到了部分恢复。术后肛门括约肌压力恢复时间为术后6个月，肛门运动、切断括约肌肌肉反射及肠道运动恢复时间约为12个月。

结论：肛瘘挂线术后可导致肛门括约肌功能障碍，但是通过术后的康复训练和运动可较好地改善肛门功能，术后1年后术后肛门功能可基本恢复正常。

关键词：肛瘘挂线术，肛门功能，康复训练，恢复，影响因素

Abstract:

Objective:Thepurposeofthisstudyistoinvestigatetherecoveryofanalfunctionafteranalfistulahangingwiresurgeryanditsinfluencingfactors.

Methods:AretrospectivecohortstudywasconductedonpatientswhounderwentanalfistulahangingwiresurgeryatourhospitalfromJanuary2014toDecember2018.Atotalof130subjectswereincludedinthestudy.Theobservationindicatorsincludedefecationfunction,analsphincterpressure,analmovement,cuttingoffthereflexofthesphinctermuscle,defecationtime,andintestinalmovement.

Results:Earlypostoperativeanalsphincterpressure,analmovement,cuttingoffthereflexofthesphinctermuscle,andintestinalmovementallhadvaryingdegreesofinjuryandobstruction.However,throughpostoperativeexerciseandrehabilitationtraining,theseinjuriesandnegativeeffectswerepartiallyrestored.Therecoverytimeofanalsphincterpressurewas6monthsaftersurgery,andtherecoverytimeofanalmovement,cuttingoffthereflexofthesphinctermuscle,andintestinalmovementwasabout12monthsaftersurgery.

Conclusion:Analfistulahangingwiresurgerycancauseanalsphincterdysfunction.However,throughpostoperativerehabilitationtrainingandexercise,analfunctioncanbesignificantlyimproved,andpostoperativeanalfunctioncanbebasicallyrestoredtonormalafteroneyear.

Keywords:analfistulahangingwiresurgery,analfunction,rehabilitationtraining,recovery,influencingfactorsAnalfistulaisacommonconditionthataffectsmanyindividualsaroundtheworld.Inmanycases,surgicalinterventionisrequiredtotreatthecondition.Thehangingwiresurgery,oneofthemethodsusedfortreatinganalfistula,helpstocreateapassageforthepustodrainout.Althoughthissurgeryiseffectiveintreatinganalfistulas,itcancauseanalsphincterdysfunction,whichmayaffectthepatient'sanalfunction.

Patientswhohaveundergoneanalfistulahangingwiresurgerymayexperiencesymptomssuchasincontinenceordifficultycontrollingbowelmovements,analpain,ordiscomfort.However,thesesymptomscanbeeffectivelymanagedthroughpostoperativerehabilitationtrainingandexerciseprograms.

RehabilitationprogramsmayincludepelvicfloormuscleexercisessuchasKegels,biofeedbacktherapy,andbowelretraining.Theseprogramshelptostrengthentheanalsphinctermuscles,improvecontinence,andenhanceanalfunction.Patientswhoundergotheserehabilitationprogramshavebeenshowntoexperiencesignificantimprovementsinanalfunctionandaremorelikelytorecovernormalbowelhabits.

Factorsthatmayaffectrecoveryfromanalfistulahangingwiresurgeryaretheseverityoftheinitialcondition,age,healthstatus,andtheproximityofthefistulatotheanalsphinctermuscles.Patientswhohaveacomplexfistulaorthosewhohavehadpreviousanalsurgeriesmayalsorequiremoreextensiverehabilitationprograms.

Inconclusion,analfistulahangingwiresurgerycancauseanalsphincterdysfunction,butthiscanbeeffectivelymanagedthroughpostoperativerehabilitationprograms.Withproperrehabilitationtrainingandexercise,patientscansignificantlyimproveanalfunctionandrestorepostoperativeanalfunctiontonormalafteroneyear.Factorssuchastheseverityoftheinitialcondition,age,andhealthstatusmayaffectrecoveryfromsurgery,butwithpropercare,patientscansuccessfullyovercomethecomplicationsassociatedwithanalfistulahangingwiresurgeryInadditiontopostoperativerehabilitation,lifestylechangescanalsoplayanimportantroleinrecoveryafteranalfistulahangingwiresurgery.Healthylifestylehabitssuchasawell-balanceddiet,regularexercise,andstressmanagementcanimproveimmunefunctionandreducetheriskofinfectionandrecurrenceofthecondition.

Theuseofalternativetherapiessuchasacupuncture,herbalmedicine,andhomeopathyhasalsobeenstudiedfortheirpotentialbenefitsinthemanagementofanalfistula.However,theevidencefortheireffectivenessislimited,andpatientsshoulddiscusstheseoptionswiththeirhealthcareproviderbeforeusingthemasacomplementaryoralternativetherapy.

Inconclusion,analfistulahangingwiresurgeryisaneffectiveoptionforthetreatmentofanalfistulathathasnotrespondedtootherconservativemeasures.Whiletherearepotentialcomplicationsassociatedwiththeprocedure,thesecanbemanagedthroughproperpostoperativecareandrehabilitation.Patientscanalsomakelifestylechangesthatcanimprovetheiroverallhealthandreducetheriskofinfectionandrecurrence.Byworkingcloselywiththeirhealthcareprovider,patientscansuccessfullymanageandovercomethechallengesofanalfistulahangingwiresurgeryPatientswhohaveundergoneanalfistulahangingwiresurgerywillneedtobediligentintheirpostoperativecareandrehabilitationtominimizetheriskofcomplicationsandrecurrence.Commoncomplicationsassociatedwiththeprocedureincludeinfection,bleeding,andanalincontinence.

Toreducetheriskofinfection,patientsshouldkeepthesurgicalareacleanandapplyanantisepticointmentasdirected.Theyshouldavoidsittingforprolongedperiodsoftimeandengageinlightexercise,suchaswalkingorgentlestretching,tomaintaingoodcirculation.

Bleedingmayoccurimmediatelyafterthesurgery,butitshouldsubsidewithinafewdays.Ifbleedingpersistsorbecomessevere,patientsshouldcontacttheirhealthcareprovider.Analincontinenceisapotentiallong-termcomplicationthatpatientswillneedtomanagethroughlifestylechanges,suchasconsumingahigh-fiberdietandpracticinggoodbowelhabits.

Patientsshouldalsoattendfollow-upappointmentswiththeirhealthcareprovidertomonitortheirprogressandensurethatanycomplicationsaredetectedandtreatedearly.Itisimportantforpatientstocommunicateopenlywiththeirhealthcareprovideraboutanyconcerns,symptoms,orchangesintheircondition.

Inadditiontoproperpostoperativecareandrehabilitation,patientscantakestepstoimprovetheiroverallhealthandwell-being.Thisincludesadoptingahealthylifestylethatincludesregularexercise,abalanceddiet,and