目的 探究非热远红外线照射联合藻酸盐银离子敷料促进肛瘘创面愈合的临床疗效。方法 选取2023年7月—2024年6月于肛肠外科接受治疗的肛瘘患者90例为研究对象,按随机数字表法分为试验组和两组对照组（每组各30例）,试验组患者接受非热远红外线照射联合藻酸盐银离子敷料治疗,第一对照组患者接受藻酸盐银离子辅料治疗,第二对照组患者接受非热远红外线照射治疗。比较三组患者术后的创面局部情况（如创面疼痛程度、渗血渗液和愈合情况）,总体疗效,创面渗液生物分子指标[血管内皮生长因子（VEGF）、基质金属蛋白酶2（MMP-2）和组织金属蛋白酶抑制剂-1（TIMP-1）]及全身炎症因子[血清淀粉样蛋白A（SAA）、白细胞介素6（IL-6）、降钙素原（PCT）]水平。结果 术后3、5及10 d,试验组患者的视觉模拟评分法（VAS）评分、创面渗血渗液评分低于第一、第二对照组,创面愈合速率高于第一、第二对照组,创面愈合天数少于第一、第二对照组,差异均有统计学意义（P<0.05）。试验组总有效率显著高于第一、第二对照组（P<0.05）。术后7 d,试验组患者创面渗液的VEGF和TIMP-1水平显著高于第一、第二对照组,MMP-2水平则显著低于第一、第二对照组（均P<0.05）;试验组患者血清SAA、IL-6和PCT水平显著低于第一、第二对照组（P<0.05）。结论 非热远红外线照射联合藻酸盐银离子敷料对肛瘘患者创面愈合的临床疗效显著优于单独使用非热远红外线照射或藻酸盐银离子敷料,值得在临床推荐使用。

Objective To investigate the clinical efficacy of non-thermal far-infrared irradiation combined with alginate silver ion dressing in promoting anal fistula wound healing. Methods A total of 90 patients with anal fistula who received treatment in the Department of Anorectal Surgery at our hospital from July 2023 to June 2024 were selected and randomly divided into an experimental group and two control groups （30 cases in each group）. The patients in the experimental group received treatment with non-thermal far-infrared irradiation combined with alginate silver ion dressing, those in the first control group received alginate silver ion dressing, and those in the second control group received non-thermal far-infrared irradiation. The local wound conditions （such as the degree of wound pain, bleeding and exudation, and healing condition）, overall efficacy, biomolecular indexes of wound exudate [vascular endothelial growth factor （VEGF）, matrix metalloproteinase 2 （MMP-2）, and tissue inhibitor of metalloproteinases-1 （TIMP-1）], and inflammatory factors [serum amyloid A （SAA）, interleukin 6 （IL-6）, and procalcitonin （PCT）] were compared between the three groups. Results On the 3rd, 5th, and 10th days after surgery, the visual analog scale （VAS） scores of the experimental group were significantly lower than those of the first and second control groups, the wound healing rate was significantly higher, and the wound healing period was significantly shorter （P<0.05）. The total effective rate of patients in the experimental group was significantly higher than those in the first and second control groups （P<0.05）. On the 7th day after surgery, the levels of VEGF and TIMP-1 in wound exudate in the experimental group were significantly higher than those in the first and second control groups, while the levels of MMP-2 were significantly lower （P<0.05）; the inflammatory factor levels of serum SAA, IL-6, and PCT in the experimental group were significantly lower than those in the first and second control groups （P<0.05）. Conclusion The clinical efficacy of non-thermal far-infrared irradiation combined with alginate silver ion dressing on wound healing in patients with anal fistula is significantly better than that of non-thermal far-infrared irradiation or alginate silver ion dressing alone, and it is worth clinical promotion.