MRI引导下改良TROPIS挂线结合转换取线在高位肛瘘治疗的临床疗效研究  

Clinical efficacy of modified TROPIS in treatment of high anal fistula under guidance of MRI and combined with conversion suture

作　　者：董树江[1] 杨柏霖[2] 莫琪[1] 徐素婷 陈丙学 DONG Shujiang;YANG Bolin;MO Qi;XU Suting;CHEN Bingxue(Department of Anorectal Surgery,Changzhou No.2 Peoples'Hospital,The Third Affiliated of Nanjing Medical University,Changzhou Jiangsu 213161,China;Department of Anorectal Surgery,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Affiliated to Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京医科大学第三附属医院常州第二人民医院肛肠外科,江苏常州213161 [2]南京中医药大学附属江苏省中医院肛肠科,南京210029

出　　处：《新疆医科大学学报》2025年第3期334-337,343,共5页Journal of Xinjiang Medical University

基　　金：江苏省科技计划专项资金项目(BE2023792)。

摘　　要：目的研究磁共振成像(Magnetic resonance imaging,MRI)引导下改良TROPIS挂线结合术后转换取线在治疗高位肛瘘的临床疗效。方法以2020年1月-2024年9月常州第二人民医院肛肠外科收治的parks分型为经括约肌型、括约肌上型的100例高位肛瘘患者为研究对象,根据治疗方法的不同分为试验组(n=40)和对照组(n=60)。试验组采用改良TROPIS挂线结合转换取线方法治疗,对照组采用传统切开挂线方法治疗。比较两组患者的一般资料、手术时间、住院时间、创面愈合时间、肛门疼痛评分、治愈率、肛门功能评分、术后并发症的发生情况。结果与对照组比较,试验组创面愈合时间和住院时间缩短,Wexner失禁评分降低,手术时间延长,漏气漏液和锁眼样畸形发生率降低,差异有统计学意义(P<0.05)。两组治愈率、术后肛门疼痛评分及尿潴留发生率比较,差异无统计学意义(P>0.05)。结论MRI引导下改良TROPIS挂线结合转换取线在高位肛瘘的治疗中,具有缩短创面愈合时间、减轻肛门功能损伤、降低术后并发症的优点,可开展临床推广。Objective To observe the clinical efficacy of modified TROPIS hanging line under the guidance of MRI combined with conversion suture in the treatment of high anal fistula.Methods 100 patients with high anal fistula admitted to the hospital from January 2020 toSeptember 2024 were selected,and their parks type was classified into transsphincter type and suprasphincter type.According to the different treatment methods,thepatients were divided into experimental group(n=40)and control group(n=60).The experimental group was treated with modified TROPIS hanging line combined with conversion suture,while the control group was treated with traditional incision and hanging technique.The general data,operation duration,length of hospital stay,wound healing duration,anal pain score,cure rate,anal function score and incidence of adverse complications were compared between the 2 groups.Results Compared with the control group,the experimental group had a shorter wound healing time and hospitalization time,a lower Wexner incontinence score,a longer surgical time,and a lower incidence of air leakage,fluid leakage and keyhole like deformities,with statistically significant differences(P<0.05).There was no significant difference in the cure rate,postoperative anal pain score and incidence of urinary retention between the 2 groups(P>0.05).Conclusion In the treatment of high anal fistula,the modified TROPIS hanging line under the guidance of MRI combined with conversion suture has the advantages of shortening wound healing time,alleviating anal functional injury and reducing postoperative complications,and it is suitable for clinical promotion.

关 键 词：高位肛瘘 改良TROPIS挂线术 肛门功能 转换取线 

分 类 号：R657.16[医药卫生—外科学]