高位挂线加低位脱细胞真皮基质填塞治疗高位复杂性肛瘘(1)
摘要：目的 探究高位挂线加低位脱细胞真皮基质(AEM)填塞治疗高位复杂性肛瘘。方法 选取于2017年3月～2018年3月安徽医科大学附属合肥市第二人民医院收治的56例高位复杂性肛瘘患者作为研究对象，随机分为治疗组和对照组，每组28例。治疗组给予AEM治疗，对照组给予以传统瘘管切开挂线术治疗，比较两组患者的治疗效果、治愈率及复发率。结果 治疗组的疼痛持续时间、伤口愈合时间均短于对照组(P<0.05);其术后并发症总发生率及复发率分别为3.57%和0，均低于对照组的39.28%和7.14%，差异有统计学意义(P<0.05);治疗组治愈率为85.71%，高于对照组的71.43%，差异有统计学意义(P<0.05)。结论 对高位复杂性肛瘘患者采取高位挂线加低位脱细胞真皮基质填塞治疗疗程短，治愈率高，复发率低，临床治疗上具有一定的优势。
关键词：脱细胞真皮基质;高位;复杂性肛瘘
中图分类号：R657.1+6 文獻标识码：A DOI：10.3969/j.issn.1006-1959.2019.03.036
, http://www.100md.com
文章编号：1006-1959(2019)03-0116-03
Abstract：Objective To explore the treatment of high complex anal fistula with high hanging wire and low acellular dermal matrix (AEM) tamponade.Methods 56 cases of patients with high complex anal fistula admitted to hefei second people's hospital affiliated to anhui medical university from March 2017 to March 2018 were selected as research objects， and randomly divided into treatment group and control group， 28 cases in each group.The treatment group was treated with AEM， and the control group was treated with traditional fistula incision and thread hanging. The treatment effect， cure rate and recurrence rate of the two groups were compared.Results The duration of pain and wound healing time in the treatment group were significantly shorter than those in the control group (P<0.05).The total incidence and recurrence rates of postoperative complications were 3.57% and 0， both lower than the control group's 39.28% and 7.14%， with statistically significant differences (P<0.05).The cure rate in the treatment group was 85.71%， higher than that in the control group (71.43%)， and the difference was statistically significant (P<0.05).Conclusion The treatment course of high hanging wire and low acellular dermal matrix tamping for patients with high complex anal fistula is short with high cure rate and low recurrence rate.
, 百拇医药
Key words：Acellular dermal matrix;High;Complex anal fistula
肛瘘(anal fistula)治疗的主要目的在于切除肛瘘内口和其上皮化瘘管，减少对括约肌的实际损伤。临床上在解决保护肛门功能和根治肛瘘之间的权衡存在一定的困难，尤其是治疗高位复杂性肛瘘，其原因主要在于病变位置比较高、管道多而复杂、深部死腔多存在支管，治疗难度极大[1]。如果手术处理不当，极容易出现肛门狭窄、肛门失禁、肛门畸形及其他严重并发症，或者瘘管未彻底清除导致复发率较高[2]。目前，临床上仍然会使用传统肛瘘手术治疗肛瘘，虽然临床效果显著，但存在创伤大、肛门损害严重、肛门愈合时间较长等缺点，多数患者不愿接受。本研究对高位复杂性肛瘘患者给予高位挂线加低位脱细胞真皮基质填塞、传统瘘管切开挂线术治疗，取得一定效果，现报道如下。, 百拇医药(李龙)
关键词：脱细胞真皮基质;高位;复杂性肛瘘
中图分类号：R657.1+6 文獻标识码：A DOI：10.3969/j.issn.1006-1959.2019.03.036
, http://www.100md.com
文章编号：1006-1959(2019)03-0116-03
Abstract：Objective To explore the treatment of high complex anal fistula with high hanging wire and low acellular dermal matrix (AEM) tamponade.Methods 56 cases of patients with high complex anal fistula admitted to hefei second people's hospital affiliated to anhui medical university from March 2017 to March 2018 were selected as research objects， and randomly divided into treatment group and control group， 28 cases in each group.The treatment group was treated with AEM， and the control group was treated with traditional fistula incision and thread hanging. The treatment effect， cure rate and recurrence rate of the two groups were compared.Results The duration of pain and wound healing time in the treatment group were significantly shorter than those in the control group (P<0.05).The total incidence and recurrence rates of postoperative complications were 3.57% and 0， both lower than the control group's 39.28% and 7.14%， with statistically significant differences (P<0.05).The cure rate in the treatment group was 85.71%， higher than that in the control group (71.43%)， and the difference was statistically significant (P<0.05).Conclusion The treatment course of high hanging wire and low acellular dermal matrix tamping for patients with high complex anal fistula is short with high cure rate and low recurrence rate.
, 百拇医药
Key words：Acellular dermal matrix;High;Complex anal fistula
肛瘘(anal fistula)治疗的主要目的在于切除肛瘘内口和其上皮化瘘管，减少对括约肌的实际损伤。临床上在解决保护肛门功能和根治肛瘘之间的权衡存在一定的困难，尤其是治疗高位复杂性肛瘘，其原因主要在于病变位置比较高、管道多而复杂、深部死腔多存在支管，治疗难度极大[1]。如果手术处理不当，极容易出现肛门狭窄、肛门失禁、肛门畸形及其他严重并发症，或者瘘管未彻底清除导致复发率较高[2]。目前，临床上仍然会使用传统肛瘘手术治疗肛瘘，虽然临床效果显著，但存在创伤大、肛门损害严重、肛门愈合时间较长等缺点，多数患者不愿接受。本研究对高位复杂性肛瘘患者给予高位挂线加低位脱细胞真皮基质填塞、传统瘘管切开挂线术治疗，取得一定效果，现报道如下。, 百拇医药(李龙)