肛瘘术前评估方法的研究进展  

Methods for preoperative assessment of anal fistula

作　　者：王永刚[1] 丁健华[1] 赵克[1] 

机构地区：[1]中国人民解放军第二炮兵总医院结直肠肛门外科,北京市100088

出　　处：《世界华人消化杂志》2014年第16期2265-2270,共6页World Chinese Journal of Digestology

基　　金：首都临床特色应用研究基金资助项目;No.Z121107001012135

摘　　要：肛瘘是最常见的肛周疾病之一,其术前评估方法多种多样,传统方法包括查体、探针探查、Goodsall定律、亚甲蓝试验等,尽管传统方法发挥了一定的作用,但其对复杂性肛瘘诊断准确率低,须与其他方法联合应用.瘘管X线造影无法明确瘘管与括约肌的关系,CT成像技术对区分瘘管组织与周围肌肉缺乏特异性,二者现已很少应用.核磁共振和三维肛管直肠腔内超声已逐渐成为肛瘘术前常规的检查方法,对指导精准手术发挥了重要作用,但二者也存在各自的缺点.本文将对各种肛瘘术前评估方法作一综述.Anal fistula is one of the most common perianal diseases, and methods for its preoperative assessment are diverse. Traditional methods include physical examination, probing, Goodsall’s law, methylene blue test, and so on. Although traditional methods play a role, their accuracy for complex anal fistulas is low. Therefore, their application must be combined with other methods. Fistulography fails to depict the relationship of the fistula to the sphincter complex, and computed tomography lacks specificity to distinguish between fistula and surrounding muscle tissue. Both methods are rarely used now. Magnetic resonance imaging and three-dimensional anorectal endosonography have become routine preoperative examinations and play an important role for guiding precise surgery. However,they also have their own shortcomings. In this paper, we will summarize a variety of methods for preoperative assessment of anal fistula.

关 键 词：肛瘘 术前评估方法 核磁共振 三维肛管直肠腔内超声 

分 类 号：R657.1[医药卫生—外科学]