复杂肛瘘彩超介入下瘘管切除缝合术的临床研究_临床医学论文.docVIP

复杂肛瘘彩超介入下瘘管切除缝合术的临床研究_临床医学论文 复杂肛瘘彩超介入下瘘管切除缝合术的临床研究_临床医学论文 【摘要】 目的 根据高频彩色超声波检查复杂性肛瘘的声像学特点，做术前定位分析，用瘘管切除缝合术治疗复杂肛瘘的临床研究。方法 用高频彩色超声波做术前检查肛瘘73例，并与常规专科检查结果及切开挂线自行愈合时间相比较，作肛瘘瘘管切除缝合术的疗效和可行性分析。结果 依据肛周高频彩超术前检查肛瘘声像图的表现，肛瘘周围区域未测及血流信号，扫查肛瘘瘘管及支管的数目及瘘口位置，为手术切除肛瘘瘘管，做一期缝合术，缩短手术后恢复时间，提高疗效创造条件。结论 依据肛周高频彩超用于肛瘘的术前检查定位，同时显示肛瘘的位置、形态、保存图像等方面的优点，为肛瘘瘘管切除缝合手术的成功疗效提供客观依据。 【关键词】 复杂肛瘘；高频彩超；切除缝合；治疗效果 Clinical research on fistula resection and suture operation with color ultrasonic intervention for complicated anal fistula ［Abstract］ Objective According to the high frequency color ultrasonic inspection for complex anal fistula,do location before treatment and fistula resection and suture operation.Methods Using high-frequency ultrasound do color preoperative examination for 73 cases compared with normal examination results，and hanged line healing time，the suture and fistula canal resection in feasibility was analyzed.Results According to the high frequency color Doppler ultrasound in perianal preoperative examination materials，canal and around area of the canal scanning blood sign,fistula canal and the number of tubes and fistula position for surgical resection were done，shortened the time and improved the recovery after surgery in curative effect.Conclusion According to the high frequency color Doppler ultrasound in preoperative examination positioning，also showing the canal，and saving the image，for the surgical resection of the fistula canal successfully provides an objective basis for curative effect. ［Key words］ complex rectal fistula;high-frequency color ultrasonic;resection and suture;therapeutic effect 肛瘘又称肛门直肠瘘，是肛管或直肠与肛周皮肤相通的肉芽肿性管道，由内口、瘘管、外口三部分组成。经久不愈或间歇性反复发作而引发复杂性肛瘘。复杂性肛瘘中高位肛瘘手术方法繁多，对治疗复杂性肛瘘的疗效问题观点不同。如术前诊断不细致及术中或术后等处理不当，可引起肛门失禁、出血、复发等各种并发症。我院近8年来采用高频彩超做术前检查介入下行肛瘘瘘管切除缝合术，治疗73例复杂性肛瘘，其中包括5例高位复杂性肛瘘、35例马蹄形肛瘘、33例多外口（2～4个）非马蹄形肛瘘，全部治愈，随访两年均无复发。治疗效果满意，现介绍如下。 1 资料与方法 1.1 一般资料 本组73例，男47例，女26例。年龄最小17岁，最大72岁，以24～45岁居多，共62例，占85%；其中包括5例高位复杂性肛瘘、35例马蹄形肛瘘、33例多外口（2～4个）非马蹄形肛瘘；病程最短5个月，最长31年；合并痔29例（40%），