| 张 立,白晓林,李旭照,白兆福,马小娟,丁彦军,孙广宏.术前经直肠腔内三维超声诊断复杂性肛瘘内口、分型的临床价值及对手术疗效的影响[J].,2024,(2):285-288 |
| 术前经直肠腔内三维超声诊断复杂性肛瘘内口、分型的临床价值及对手术疗效的影响 |
| Clinical Value of Transrectal Three-dimensional Ultrasound before Surgery in the Diagnosis and Classification of Internal Opening of Complex Anal Fistula and Its Impact on Surgery Efficacy |
| 投稿时间：2023-07-04 修订日期：2023-07-23 |
| DOI：10.13241/j.cnki.pmb.2024.02.015 |
| 中文关键词: 经直肠腔内三维超声 复杂性肛瘘 分型 肛门功能 手术疗效 |
| 英文关键词: Transrectal three-dimensional ultrasound Complex anal fistula Classification Anal function Surgery efficacy |
| 基金项目:宁夏回族自治区自然科学基金项目（2021AAC03304） |
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| 中文摘要: |
| 摘要 目的：探讨术前经直肠腔内三维超声诊断复杂性肛瘘内口、分型的临床价值及对手术疗效的影响。方法：选择2021年1月至2022年6月我院收治拟行手术治疗的复杂性肛瘘患者84例，按照数字随机法分为研究组和对照组，每组42例。对照组术前行经直肠腔内常规超声检查，研究组术前行经直肠腔内三维超声检查。比较两组肛瘘内口术前诊断准确率、Parks分型检出准确率、手术疗效、住院时间、创口愈合时间，术前与术后肛门功能、术后并发症发生情况及复发率。结果：研究组肛瘘内口术前诊断准确率显著高于对照组（P<0.05）。研究组括约肌间型、经括约肌型、括约肌上型、括约肌外型术前诊断准确率显著高于对照组（P<0.05）。研究组治愈率为66.67%，显著高于对照组的42.86%（P<0.05）。研究组患者术后6个月肛门失禁Wexner 评分均显著低于对照组（P<0.05），研究组患者住院时间、创面愈合时间均短于对照组（P<0.05）。两组术后并发症发生率、6个月内复发率比较无统计学差异（P>0.05）。结论：经直肠腔内三维超声诊断能够准确诊断肛瘘内口、瘘管走行，有利于提升复杂性肛瘘总体治疗效果，保护肛门功能。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical value of transrectal three-dimensional ultrasound before in the diagnosis and classification of internal opening of complex anal fistula and its impact on surgery efficacy. Methods: 84 patients with complex anal fistula who were admitted to our hospital for surgery treatment from January 2021 to June 2022 were selected, they were divided into study group and control group according to the random number method, 42 cases per group. Control group underwent routine transrectal ultrasound examination before surgery, and study group underwent transrectal three-dimensional ultrasound examination before surgery. The diagnostic accuracy rate before surgery, Parks type accuracy rate, surgery efficacy, hospital time, wound healing time, anal function before surgery and after surgery, complications after surgery, and recurrence rate of internal opening of anal fistula were compared between two groups. Results: The diagnostic accuracy rate before surgery of internal opening of anal fistula in study group was significantly higher than that in control group (P<0.05). The diagnosis accuracy rate before surgery of sphincter intersternal type, trans sphincter type, sphincter upper type, sphincter appearance type in study group were significantly higher than those in control group (P<0.05). The cure rate in the study group was 66.67%, significantly higher than 42.86% in the control group (P<0.05). The Wexner score of anal incontinence in the study group was significantly lower than that in the control group at 6 months after surgery (P<0.05), and the hospital stay and wound healing time in the study group were shorter than those in the control group (P<0.05). There was no statistically significant difference in the incidence of complications after surgery and recurrence rate within 6 months between two groups (P>0.05). Conclusion: Transrectal three-dimensional ultrasound diagnosis can accurately diagnose the opening and course of anal fistula, which is beneficial for improving the overall treatment effect of complex anal fistula, and protecting anal function. |
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