过氧化氢造影增强直肠腔内超声在诊断肛瘘中的应用

Clinical applications of hydrogen peroxide-enhanced anal endosonography technique in fistula-in-ano

目的探讨过氧化氢造影增强直肠腔内超声技术在诊断肛瘘中的意义。方法对22例临床诊断为复杂肛瘘的住院患者术前进行常规直肠腔内超声检查,之后将3%过氧化氢溶液通过细胶管注入肛瘘外口,进行过氧化氢造影增强直肠腔内超声检查,观察瘘道内口、主支、分支和肛瘘慢性脓腔的位置及数量,将其结果与术中所见进行比较。结果常规直肠腔内超声与过氧化氢造影增强直肠腔内超声对内口的判断准确率分别为32%和100%(P<0.01),对主支位置的判断准确率分别为82%和95%(P>0.05),对分支的判断准确率分别为73%和91%(P>0.05)。结论过氧化氢造影增强直肠腔内超声较常规直肠腔内超声对肛瘘的诊断准确率显著提高,有助于临床治疗方案的制定。

Objective To evaluate hydrogen peroxide - enhanced anal endosonography in the diagnosis of fistula - in - ano and to compare it with standard ultrasound technique. Methods Twenty - two patients with fistula - in - ano were evaluated by physical examination,conventional anal endosonography and hydrogen peroxide - enhanced anal endosonography before surgery. Hydrogen peroxide （3%） was infused via a small catheter into the fistula. The results of anal endosonography and hydrogen peroxide - enhanced anal endosonography were compared with surgical findings. Results Diagnostic accuracies of conventional anal endosonography and hydrogen peroxide - enhanced anal endosonography were 32% and 100% for identifying the location of internal opening,82% and 95 % for category of fistulou stracks,73% and 91% for secondary extensions,respectively. Conclusions Hydrogen peroxide - enhanced anal endosonography is much more superior to standard anal endosonography in delineating the anatomic pathway of perianal fistulas. It may be of value for surgeon to make a therapeutic scheme.