复发性肛瘘的诊治(附45例报告)

Diagnosis and Treatment of Recurrent Fistula

目的 :提高肛瘘的一次性治愈率 ,减少肛瘘术后复发率 ,分析肛瘘再手术的原因。方法 :1998年 10月至 2 0 0 3年 10月收治曾在外医院行肛瘘手术后又复发肛瘘病例 4 5例 ,用亚甲蓝和过氧化氢混合液作外口注射染色加探针寻找内口 ,切开瘘道清除腐朽坏死及瘢痕组织后 ,抗生素冲洗伤口后作一期缝合 ,内口切开引流或切开挂线引流。术后针对不同原因采用中西医结合治疗 ,外加中药薰洗、坐浴。结果 :4 5例全部临床治愈 ,治愈率达 10 0 %。结论 :肛瘘手术完全能一次治愈。关键在于治疗过程中应注意内口 (原发感染灶 )与合并症的正确处理。

Objective:To raise cure rate of fistula and to analysis the reason of re-operation of fistula.Methods:45 cases patients with recurrent fistula and once operated in other hospitals were identified in our hospital from October,1998 to October,2003. We look for internal openings by injecting an mixed juice of hydrogen peroxide and methylenum coeruleum or by draging the system of fistula,resecting the side fistula tract and irrigating incision and interrupted suture,and then have the main fistula tract half resected,incise the internal opening,ligate the two flaps,and make cutting setion of anal sphincter and drainaged.Results:The cure rate of 45 cases is 100 percent,and the mean curative period was 16 days.Conclusion:Fistula can be cured by operation,and important steps are the treatments of internal opening and the treatments of postoperative complication.