Abstract：Objective: To explore the influence of contra-incision combined with high loose-tight thread on the levels of interleukin-6 (IL-6) and interleukin-17 (IL-17) and wound healing time in patients with high complex anal fistula (CAF).Methods: The clinical data of 130 patients with high CAF who received surgical treatment in the hospital were retrospectively analyzed from January 2021 to October 2023. According to the differences in surgical methods, the subjects were divided into contra-incision group (contra-incision combined with high loose-tight thread, n=68) and traditional group (traditional incision and thread-drawing, n=62). The therapeutic effect, postoperative wound healing status, wound symptoms scores and levels of IL-6 and IL-17 before surgery and at 1 week after surgery, Wexner anal incontinence score and anal sphincter function indexes [anal resting pressure (ARP), anal maximum contraction pressure (AMCP)] before surgery and at 3 months after surgery were compared between the contra-incision group and the traditional group, and the incidence of complications was recorded.Results: There was no statistical significance in the total effective rate of treatment between contra-incision group and traditional group (98.53% vs 95.16%) (P>0.05). Compared with the traditional group, the postoperative wound healing time and hospitalization time in the contra-incision group were shorter, and the wound healing rate was higher (P<0.05). At 1 week after surgery, the wound symptoms scores in both groups were reduced, and the reductions were greater in the contra-incision group (P<0.05). The levels of IL-6 and IL-17 were decreased in both groups at 1 week after surgery, and the decreases in the contra-incision group were greater compared to the traditional group (P<0.05). The Wexner anal incontinence score, AMCP and ARP at 3 months after surgery were declined in the two groups, and the declines in the contra-incision group were greater (P<0.05). No statistical difference was shown in the incidence of urinary retention between the contra-incision group and the traditional group (1.47% vs 3.23%) (P>0.05).Conclusion: Both contra-incision combined with high loose-tight thread and traditional surgery have good effects in the treatment of high CAF. Both the two methods have high safety and can effectively reduce the influence of surgery on the anal sphincter. However, compared with the traditional surgery, contra-incision combined with high loose-tight thread can more significantly shorten the wound healing time, accelerate the recovery of wound-related symptoms, and down-regulate the body’ s inflammation level, and it is more conducive to accelerating the rehabilitation process of patients, and can be the first choice for the treatment of high CAF.
谢永俊, 穆永保, 张雁, 张明金. 对切松紧高挂术治疗对高位复杂性肛瘘患者IL-6 IL-17水平及创面愈合时间的影响[J]. 河北医学, 2024, 30(12): 2011-2016.
XIE Yongjun, MU Yongbao, ZHANG Yan, et al. Influence of Contra-Incision Combined with High Loose-Tight Thread on IL-6 IL-17 and Wound Healing Time in Patients with High Complex anal Fistula. HeBei Med, 2024, 30(12): 2011-2016.
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2024, Vol. 30 
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