超声在肛周脓肿及肛瘘中的辅助诊断价值  

Value of ultrasound in the diagnosis of perianal infectious diseases

作　　者：陈晓婷[1] 王东平[1] 周建[1] 

机构地区：[1]滁州市第一人民医院超声科,安徽滁州239000

出　　处：《结直肠肛门外科》2016年第5期482-484,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨超声在肛周脓肿及肛瘘的辅助诊断价值。方法选取2015年2月至2016年2月本院收治的272例肛周脓肿或肛瘘患者为研究对象,术前进行肛管及周围软组织超声扫描检查,以手术病理结果为金标准,分析超声诊断肛周脓肿、肛瘘的准确性,并观察其判断肛周脓肿分期及分型、肛瘘分型及肛瘘内口、瘘管的准确性。结果 176例肛周脓肿及96例肛瘘均经超声检出,与病理结果完全吻合。超声诊断肛周脓肿分期准确率为98.86%(174/176),2例中期误诊为早期;超声诊断肛周脓肿分型准确率98.86%(174/176),2例Ⅴ型误诊为Ⅳ型。超声诊断肛瘘分型准确性为96.88%(93/96),3例复杂性肛瘘误诊为括约肌间型肛瘘。超声诊断肛瘘内口、主管、瘘管准确率分别为97.46%、100%、90.63%。结论超声诊断是肛周脓肿及肛瘘的有效辅助检测手段,可为分型、分期等病理情况的判断提供依据,从而为临床治疗方案的制定提供参考。Objective To investigate the value of uhrasonography in the diagnosis of perianal abscess and anal fistula. Methods 272 patients with perianal abscess and anal fistula were recruited from our hospital from February 2015 to February 2016. Ultrasonic scan- ning of anal tube and surrounding soft tissues was performed before the surgery. Findings from the surgery and pathology were regarded as the golden standard. The accuracy of ultrasound in diagnosis of perianal abscess and anal fistula were analyzed. The accuracy rates in staging and type of perianal abscess, type of anal fistula, anal fistula internal opening and fistula were analyzed. Results 176 cases of perianal abscess and 96 cases of anal fistula were detected by ultrasound. The ultrasonic findings were fully consistent with the pathological results, with sensitivity of 100% and specificity of 100%. Tile accuracy of staging of ultrasound for anal abscess was 98.86% （174/176）, with 2 mid-stage cases misclassified as early stage. The accuracy of type classification of ultrasound for anal ab- scess was 98.86% （174/176）, with 2 cases misclassified as type IV and type V, respectively. The accuracy of type classification of ul- trasound for anal fistula classification was 96.88% （93/96）, with 3 cases of complex anal fistula misdiagnosed as intersphineteric anal fistula. The diagnostic accuracy of ultrasound for anal fistula in the mouth, head, and fistula were 97.46%, 100%, 90.63%, respectively. Conclusion Ultrasound is an effective means of diagnosing perianal abscess and anal fistula. It can be used for type classification and staging, providing basis for designing treatment plan.

关 键 词：肛周脓肿 肛瘘 超声 诊断 

分 类 号：R657.1[医药卫生—外科学]