CO_2激光治疗肛瘘185例报告

CO 2 Laser Treatment of Anal Fistula A Report of 185 Cases

为总结ＣＯ２激光治疗肛瘘的方法及经验，应用ＣＯ２激光治疗１８５例肛瘘患者。低位单纯性肛瘘１６５例、低位复杂性肛瘘１４例、高位单纯性肛瘘３例、高位复杂性肛瘘３例。采用布比卡因、亚甲蓝肛管部浸润麻醉，持ＣＯ２激光沿瘘管外壁剔除全部瘘管；或者切开全部瘘管后，用激光光束汽化、凝固管腔内的腐烂组织及管壁的瘢痕组织。高位瘘管应与挂线疗法相结合，范围广泛的肛瘘应分期手术。经１～６年临床观察，痊愈者１８３例（治愈率９８．９％）、复发２例（复发率１．１％）。该法具有止血效果好、抗感染作用强、术后痛苦小、瘢痕小、肛门不变形、操作简单、不需住院等优点。

This article reports the results and our experience in treatment of anal fistulae by CO 2 laser surgery. Since 1988, 185 cases with anal fistula were treated using this technique. There were 146 male and 39 female, aged 15-82 years old, including 165 cases of simple low fistulae, 14 complex low fistulae, 3 simple high, and 3 complex high fistulae. Under local anesthesia (bupicaine and methylene blue), the fistulae were excised or opened by CO 2 laser cuting, vaporization, coagulation and irradiation. Complex fistulae should be treated in stages. The procedure of rubber ligature was a better choice for the upper part of the fistula. 183 patients (98 9%) were cured and 2 (1 1%) had recurrence at 1-6 years postoperatively. Cicatrization, postoperative pain, and healing time could be lessened by CO 2 laser surgery. It seemed to us that this new technique is simple and effective and can be completed without hospitalization.