肛周克罗恩病型肛瘘的外科诊疗进展  

Advances in surgical diagnosis and treatment of perianal fistulizing Crohn’s disease

作　　者：刘志伟 闫飞虎 高春芳 贾艳 于恩达 Liu Zhiwei;Yan Feihu;Gao Chunfang;Jia Yan;Yu Enda(Department of Anorectal Surgery,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Anal-colorectal Surgery Institute of People’s Liberation Army,The 989 th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army,Luoyang 471000,Henan,China;Department of Nursing,The Affiliated Suzhou Hospital of Nanjing University Medical School,Suzhou 215000,Jiangsu,China)

机构地区：[1]海军军医大学第一附属医院肛肠外科,上海200433 [2]中国人民解放军联勤保障部队第九八九医院全军肛肠外科研究所,河南洛阳471000 [3]南京大学医学院附属苏州医院护理部,江苏苏州215000

出　　处：《结直肠肛门外科》2025年第1期82-88,共7页Journal of Colorectal & Anal Surgery

基　　金：上海市卫生健康委员会临床研究专项(20224Y0075);海军军医大学第一附属医院科普创新创优资助计划(chkpfx008);海军军医大学第一附属医院基础研究专项面上项目(2023PY13);海军军医大学“深蓝”人才工程(2025年度);海军军医大学第一附属医院“长风”人才工程(202401)。

摘　　要：肛周病变是克罗恩病的首发或最重要的临床表现之一,肛周克罗恩病型肛瘘是最常见的并发症之一。肛周克罗恩病型肛瘘的患病率较高,约占克罗恩病的17%~43%。肛周克罗恩病型肛瘘患者预后差,生活质量低。目前,外科治疗仍是治疗肛周克罗恩病型肛瘘的重要方法。传统的手术方法包括瘘管切开术、肛瘘挂线术、括约肌间瘘管结扎术等。间充质干细胞注射疗法、高压氧疗法及其他新兴治疗方式的出现为肛周克罗恩病型肛瘘的治疗提供了更多的选择。准确诊断肛周克罗恩病型肛瘘,重视儿童、妊娠期妇女等特殊人群的治疗,在控制炎症的基础上实施适当的外科治疗至关重要。Perianal lesions are one of the initial or most significant clinical manifestations of Crohn’s disease,and perianal fistulizing Crohn’s disease(pfCD)is one of the most common complications.The prevalence of pfCD is relatively high,accounting for approximately 17%to 43%of Crohn’s disease patients.Patients with pfCD have poor prognosis and low quality of life.Currently,surgical treatment remains an important approach for treating pfCD.Traditional surgical methods include fistulotomy,seton,ligation of intersphincteric fistula tract.The emergence of mesenchymal stem cell injection therapy,hyperbaric oxygen therapy,and other emerging treatments has provided additional options for the treatment of pfCD.Accurate diagnosis of pfCD,emphasis on the treatment of special groups such as children and pregnant women,and appropriate surgical treatment on the basis of controlling inflammation is crucial.

关 键 词：肛周克罗恩病型肛瘘 外科 治疗 诊断 

分 类 号：R657.1[医药卫生—外科学]