生物材料封堵治疗肛瘘的临床探讨  

Biologic material ADM for the treatment of anal fistula

作　　者：马木提江·阿巴拜克热[1] 温浩[2] 黄宏国[1] 阿力木江·阿布力米提[1] 楚慧[1] 路明[1] 常忠生[1] 艾尔哈提·胡塞音[1] 范凯[1] 

机构地区：[1]新疆医科大学第一附属医院普通外科,乌鲁木齐830054 [2]新疆医科大学第一附属医院消化血管外科中心

出　　处：《中华普通外科杂志》2010年第10期808-810,共3页Chinese Journal of General Surgery

摘　　要：目的 观察脱细胞真皮基质（acellular dermal matrix,ADM）生物材料治疗肛瘘的有效性和安全性.方法 将102例肛瘘患者随机分成两组,每组51例,试验组采用ADM手术,对照组采用直肠黏膜瓣下移内口修补术,对两组患者的瘘管复发率、脓肿发生率、大便失禁率、肛门畸形率、术后疼痛时间、瘘管愈合时间等方面进行比较.采用卡方检验、秩和检验对数据进行分析.结果 试验组瘘管成功闭合者43例（84%）,复发3例（6%）,脓肿发生1例（2%）,术后大便失禁1例（2%）.对照组瘘管成功闭合者29例（57%）,复发13例（25%）,脓肿发生5例（10%）,术后大便失禁4例（8%）.试验组瘘管复发率低于对照组（χ^2=7.413,P＜0.05）,差异有统计学意义;疼痛时间、瘘管愈合时间等方面,试验组均优于对照组（U值分别为28.600,15.100,P＜0.05）,差异有统计学意义.结论 脱细胞真皮基质治疗肛瘘安全有效,可作为肛瘘的首选方法.Objective To investigate the efficacy and safety of a bioabsorbable material acellular dermal matrix （ADM） for the treatments of anal fistula. Methods One hundred and two cases of anal fistula were divided into two groups for ADM and traditional treatment. Recurrence rate, infection rate, fecal incontinence rate, anorectal deformity rate, postoperative pain, closure time were compared with each other.Results Success rate in ADM group was 84% （43/51 ）, fistulas （6%） recurred in 3 cases, one patient （2%） had abscess formation, one patient（2% ） had fecal incontinence. Success rate in controls was 57%（29/51）, fistula recurred in 13 out of 51 （25%）. Five patients （10%） were complicated with abscess formation, fecal incontinence in 4 cases. Fistula recurrence rate was significantly lower in ADM group than that in controls （χ^2 = 7. 413 ,P 〈 0. 05 ）. Pain lasting time and closure time in those with ADM are shorter than in controls （ U = 28. 600, 15. 100, P 〈 0. 05 ）. Conclusion ADM surgery is an effective and safe method for surgery of anal fistula.

关 键 词：直肠瘘 外科手术 生物相容性材料 

分 类 号：R686[医药卫生—骨科学]