脱细胞异体真皮基质填塞治疗肛瘘的临床应用
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摘要
目的探讨脱细胞异体真皮基质填塞在治疗肛瘘中的临床疗效。方法 2013年12月至2015年12月我院收治的64例肛瘘患者,根据不同治疗方法分为治疗组(脱细胞异体真皮基质填塞术)和对照组(肛瘘切开术或切开挂线术)各32例。比较两组术后疼痛评分、肛门失禁评分、愈合时间、复发率和治愈率情况。结果治疗组在术后疼痛时间评分、肛门失禁评分、愈合时间、肛门畸形方面比较,治疗组优于对照组,差异有统计学意义P<0.01);两组治愈率和复发率比较,差异无统计学意义(P>0.05)。结论脱细胞异体真皮基质填塞治疗肛瘘术后疼痛轻、创伤小、创面愈合时间短,较好保护了肛门功能。
Objective To explore the clinical effect of acellular extracellular matrix (AEM) in the treatment of anal fistula.Methods A retrospective analysis of clinical data of 64 patients with anal fistula from December 2013 to December 2015 in our hospital was collected.The patients were allocated into the treatment group (undergoing AEM) and control group (undergoing fistulotomy or incision-thread-drawing procedure),32 patients in every groups.Pain scores,anal incontinence scores,wound healing time,recurrence rate and cure rate were compared between the two groups.Results There was no statistic difference in recurrence rate and cure rate between the two groups (P > 0.05).The difference was statistically significant in the postoperative pain scores,anal incontinence scores,wound healing time and anal deformity between the two groups with superiority of the treatment group over the control group (P <0.05).Conclusion AEM in the treatment of anal fistula has the advantages of less pain,less trauma,shorter wound healing time and better anal control ability.
Objective To explore the clinical effect of acellular extracellular matrix (AEM) in the treatment of anal fistula.Methods A retrospective analysis of clinical data of 64 patients with anal fistula from December 2013 to December 2015 in our hospital was collected.The patients were allocated into the treatment group (undergoing AEM) and control group (undergoing fistulotomy or incision-thread-drawing procedure),32 patients in every groups.Pain scores,anal incontinence scores,wound healing time,recurrence rate and cure rate were compared between the two groups.Results There was no statistic difference in recurrence rate and cure rate between the two groups (P > 0.05).The difference was statistically significant in the postoperative pain scores,anal incontinence scores,wound healing time and anal deformity between the two groups with superiority of the treatment group over the control group (P <0.05).Conclusion AEM in the treatment of anal fistula has the advantages of less pain,less trauma,shorter wound healing time and better anal control ability.
引文
[1]谭嗣伟,梁存河,陈志雨,等.脱细胞异体真皮基质材料治疗复杂肛瘘52例[J].中国微创外科杂志,2012,12(3):228.
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[6]张永刚,张茂香,唐淑敏,等.括约肌间瘘管结扎术与切开挂线术治疗复杂性肛瘘的临床疗效比较[J].中华普通外科杂志,2012,27(11):940-941.
[7]韩加刚,王振军,赵宝成等.脱细胞异体真皮基质治疗肛瘘的愈合机制研究[J].中华胃肠外科杂志,2011,14(12):964-967.
[8]Van Koperen PJ,Horsthuis K,Bemelman WA,et a1.Perianal fistulas:developments in the classification and diagnostic techniques,anda new treatment strategy[J].Ned Tijdschr Geneeskd,2008,152(51-52):2774-2780.
[9]周雪涛,郑毅,崔金杰,等.LIFT-plug术治疗慢性单纯性肛瘘的疗效研究[J].北京医学,2017,39(1):60-64.
[10]Han JG,Wang ZJ,Zheng Y,et a1.Ligation of Intersphincteric Fistula Tract vs Ligation of the Intersphincteric Fistula Tract Plus a Bioprosthetic Anal Fistula Plug Procedure in Patients With Transsphincteric Anal Fistula:Early Results of a Multicenter Prospective Randomized Trial[J].Ann Surg,2016,264(6):917-922.
[2]王振军,宋维亮,郑毅,等.脱细胞异体真皮基质治疗肛瘘临床研究[J].中国实用外科杂志,2008,28(5):370-372.
[3]中华中医药学会肛肠分会.痔、肛瘘、肛裂、直肠脱垂的诊断标准(试行草案)[J].中国肛肠病杂志,2004,24(4):42-43.
[4]张作记.医学行为量表手册[M].北京:中华医学电子音像出版社,2007:485.
[5]Jorge JM,Wexner SD.Etiology and management of fecal incontinence[J].Dis Colon Rectum,1993,36:77-97.
[6]张永刚,张茂香,唐淑敏,等.括约肌间瘘管结扎术与切开挂线术治疗复杂性肛瘘的临床疗效比较[J].中华普通外科杂志,2012,27(11):940-941.
[7]韩加刚,王振军,赵宝成等.脱细胞异体真皮基质治疗肛瘘的愈合机制研究[J].中华胃肠外科杂志,2011,14(12):964-967.
[8]Van Koperen PJ,Horsthuis K,Bemelman WA,et a1.Perianal fistulas:developments in the classification and diagnostic techniques,anda new treatment strategy[J].Ned Tijdschr Geneeskd,2008,152(51-52):2774-2780.
[9]周雪涛,郑毅,崔金杰,等.LIFT-plug术治疗慢性单纯性肛瘘的疗效研究[J].北京医学,2017,39(1):60-64.
[10]Han JG,Wang ZJ,Zheng Y,et a1.Ligation of Intersphincteric Fistula Tract vs Ligation of the Intersphincteric Fistula Tract Plus a Bioprosthetic Anal Fistula Plug Procedure in Patients With Transsphincteric Anal Fistula:Early Results of a Multicenter Prospective Randomized Trial[J].Ann Surg,2016,264(6):917-922.