術前MRI定位技術對于復雜性肛瘺手術效果的評估

周振壽 戚婉 張祝輝 陳祖清

【摘要】 目的：分析研究術前MRI定位技術對于復雜性肛瘺手術的臨床效果。方法：選取80例2017年2月-2018年5月筆者所在醫院收治的復雜性肛瘺患者，隨機分為對照組和研究組，兩組均40例。對照組采用亞甲藍染色技術進行手術，研究組采用MRI定位技術確定瘺管相關情況，然后根據瘺管走向和內口進行手術，比較分析兩組術中發現內口數量、手術次數、愈合時間和治療效果。結果：研究組發現的內口數量顯著多于對照組，手術次數顯著少于對照組，且差異均有統計學意義（P<0.05）;雖然研究組的愈合時間較對照組短，但兩組比較差異無統計學意義（P>0.05）。研究組的治療率高達92.50%，顯著高于對照組的72.50%，差異有統計學意義（P<0.05）。結論：術前MRI定位技術應用于復雜性肛瘺手術的臨床效果顯著，值得推廣。

【關鍵詞】 復雜性肛瘺 MRI定位技術 亞甲藍染色技術 術前診斷 療效

doi：10.14033/j.cnki.cfmr.2020.02.025 文獻標識碼 B 文章編號 1674-6805（2020）02-00-03

[Abstract] Objective： To analyze the clinical effect of preoperative MRI localization technique for complex anal fistula operation. Method： From February 2017 to May 2018， 80 patients with complex anal fistula admitted to our hospital were randomly divided into the control group and the research group， with 40 cases in each group. The control group was operated with methylene blue staining technique， while the study group was operated with MRI localization technique to determine the fistula-related situation. Then， according to the fistula direction and the internal orifice， the operation was carried out. The number of internal orifices found， the number of operations， the healing time and the therapeutic effect were compared and analyzed between the two groups. Result： The number of internal orifices found in the study group was significantly more than that in the control group， the number of operations was significantly less than that in the control group， and the differences were statistically significant （P<0.05）. Although the healing time of the study group was shorter than that of the control group， but there was no significant difference between the two groups （P>0.05）. At the same time， the treatment rate of the study group was 92.50%， which was significantly higher than 72.50% of the control group （P<0.05）. Conclusion： The application of preoperative MRI localization technique in complex anal fistula surgery has a significant clinical effect and is worth popularizing.

[Key words] Complex anal fistula MRI localization technique Methylene blue staining technique Preoperative diagnosis Efficacy

First-authors address： Peoples Hospital Affiliated to Fujian University of Traditional Chinese Medicine， Fuzhou 350004， China

復雜性肛瘺是一種臨床上常見的直腸肛管疾病，由瘺管、內口和外口組成，該病自愈的可能性較小且會間歇性發作[1-2]。復雜性肛瘺患者的臨床表現主要是瘺管中形成膿腫，劇烈疼痛，膿腫破潰形成外瘺口或切開引流后癥狀有所緩解[3]。但是當外瘺口假性愈合時會再次形成膿腫，加劇疼痛，反復發作，臨床上多采用手術治療[4]。復雜性肛瘺手術成功與否的關鍵是要正確評估瘺管的走向和內口位置，同時要處理好內口、支管和病變組織，因此，術前的診斷尤為重要[5]。基于此，本研究對術前MRI定位技術用于復雜性肛瘺手術的臨床效果進行了分析研究，以期為提高復雜性肛瘺手術的成功率提供參考，現報道如下。