术前MRI定位技术对于复杂性肛瘘手术效果的评估

周振寿 戚婉 张祝辉 陈祖清

【摘要】 目的：分析研究术前MRI定位技术对于复杂性肛瘘手术的临床效果。方法：选取80例2017年2月-2018年5月笔者所在医院收治的复杂性肛瘘患者，随机分为对照组和研究组，两组均40例。对照组采用亚甲蓝染色技术进行手术，研究组采用MRI定位技术确定瘘管相关情况，然后根据瘘管走向和内口进行手术，比较分析两组术中发现内口数量、手术次数、愈合时间和治疗效果。结果：研究组发现的内口数量显著多于对照组，手术次数显著少于对照组，且差异均有统计学意义（P<0.05）;虽然研究组的愈合时间较对照组短，但两组比较差异无统计学意义（P>0.05）。研究组的治疗率高达92.50%，显著高于对照组的72.50%，差异有统计学意义（P<0.05）。结论：术前MRI定位技术应用于复杂性肛瘘手术的临床效果显著，值得推广。

【关键词】 复杂性肛瘘 MRI定位技术 亚甲蓝染色技术 术前诊断 疗效

doi：10.14033/j.cnki.cfmr.2020.02.025 文献标识码 B 文章编号 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

復杂性肛瘘是一种临床上常见的直肠肛管疾病，由瘘管、内口和外口组成，该病自愈的可能性较小且会间歇性发作[1-2]。复杂性肛瘘患者的临床表现主要是瘘管中形成脓肿，剧烈疼痛，脓肿破溃形成外瘘口或切开引流后症状有所缓解[3]。但是当外瘘口假性愈合时会再次形成脓肿，加剧疼痛，反复发作，临床上多采用手术治疗[4]。复杂性肛瘘手术成功与否的关键是要正确评估瘘管的走向和内口位置，同时要处理好内口、支管和病变组织，因此，术前的诊断尤为重要[5]。基于此，本研究对术前MRI定位技术用于复杂性肛瘘手术的临床效果进行了分析研究，以期为提高复杂性肛瘘手术的成功率提供参考，现报道如下。