磁共振成像在复杂肛瘘诊断中的应用价值  

Clinical value of magnetic resonance imaging in the diagnosis of complex anal fistula

作　　者：王改梅[1] 

机构地区：[1]临汾市人民医院影像科核磁室,山西省临汾041000

出　　处：《中国基层医药》2017年第22期3438-3441,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨磁共振成像在复杂肛瘘诊断中的临床应用价值.方法 选择复杂性肛瘘患者80例为研究对象,采用随机数字表法分为观察组40例、对照组40例.对照组依据医师临床经验,进行肛门相关检查后,结合术中亚甲蓝染色指引进行手术治疗;观察组术前行磁共振检查,其后步骤与对照组相同.比较两组术中发现肛瘘内口数量及准确情况、术后愈合时间、再次手术例数、复发率以及并发症发生情况.结果 观察组发现肛瘘内口数量为（2.1±0.2）个,显著多于对照组的（1.5±0.1）个,差异有统计学意义（t=16.971,P〈0.05）;观察组对肛门内口诊断的准确率为95.0%,显著高于对照组的52.5%（χ2=16.529,P〈0.05）;观察组术后愈合时间为（12.3±2.1）d,显著短于对照组的（16.7±2.5）d,差异有统计学意义（t=8.523,P〈0.05）;观察组再次手术率为2.5%,显著低于对照组的22.5%,差异有统计学意义（χ2=5.600,P〈0.05）;观察组发生出血、感染、肛门漏气漏液及肛门漏粪便的总发生率为5.0%,显著低于对照组的30.0%,差异有统计学意义（χ2=7.013,P〈0.05）.结论 对于肛瘘尤其是复杂性肛瘘,术前行磁共振检查,能有效地明确瘘管分布,为手术治疗提供有效指导,进而提高手术效果,减少手术并发症.Objective To evaluate the clinical value of magnetic resonance imaging in the diagnosis of complex anal fistula. Methods 80 patients with complex anal fistula were selected,and they were randomly divided into observation group（n=40） and control group（n=40） according to the digital table. The control group was treated according to the clinical experience of the physician,after the anus-related examination,combined with intraoperative methylene blue staining guidelines for surgical treatment. The observation group received the magnetic resonance imaging before operation,followed by the same steps as the control group. The number and accuracy of the anorectal fistula were compared between the two groups. The complication rate,the number of reoperation and the recurrence rate were analyzed. Results The number of incisors in the anal fistula in the observation group was （2. 1 ± 0. 2）, which was significantly higher than （1.5 ±0.1） in the control group （t=16.971,P〈0.05）. The accuracy rate of anal mouth in the observation group was 95. 0%,which was significantly higher than 52. 5% in the control group （χ2 =16.529,P〈0.05）.Thepostoperativehealingtimeoftheobservationgroupwas（12.7±2.1）days,whichwas significantly shorter than （16. 7 ± 2. 5） days of the control group（t =8. 523,P〈0. 05）. The incidence rate of bleeding,infection,anal leakage and anal fecal in the observation group was 5. 0%,which was significantly lower than 30. 0% in the control group （χ2 =7. 013,P〈0. 05）. And the rate of reoperation of the observation group was 2. 5%, which was significantly lower than 22. 5% of the control group（χ2 =5. 600,P〈0. 05）. Conclusion For anal fistula, especially complex anal fistula, magnetic resonance imaging before operation can effectively clear the distribution of fistula, provide effective guidance to surgical treatment, thereby improving the surgical results and reduce surgical complications.

关 键 词：直肠瘘 磁共振成像 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R657.16[医药卫生—诊断学]