肛瘘复发患者与治愈患者的肛门括约肌及肛瘘相关参数比较:基于肛周MRI图像

Comparison of anal sphincter-and anal fistula-related parameters between anal fistula patients who are cured and those who had recurrence:a study based on perianal magnetic resonance imaging

目的基于肛周MRI图像资料,分析肛瘘复发患者与治愈患者的肛门括约肌及肛瘘相关参数是否存在差异。方法回顾性分析2016年8月至2018年6月于上海中医药大学附属曙光医院东院肛肠科住院手术治疗且术前完善肛周MRI检查的421例肛瘘患者的临床资料,其中,复发患者64例(15.2%)。比较复发患者与治愈患者的肛门括约肌相关参数(肛门内、外括约肌厚度及肛门内外括约肌间隙距离)及肛瘘相关参数(肛瘘高度、内口高度)。结果复发患者的肛门内外括约肌间隙侧方距离及肛门内括约肌厚度大于治愈患者,差异均有统计学意义(均P<0.05);两者肛门内外括约肌间隙的前侧、后侧距离及肛门外括约肌厚度比较差异均无统计学意义(均P>0.05)。复发患者的肛瘘高度及内口高度大于治愈患者,差异均有统计学意义(均P<0.05)。结论肛瘘复发患者与治愈患者的肛瘘高度、内口高度、肛门内括约肌厚度及肛门内外括约肌间隙侧方距离存在差异,这些指标均可能对肛瘘复发有影响。

Objectives To determine if there were significant differences in anal sphincter-and anal fistula-related parameters between anal fistula patients who were cured and patients who had recurrence by using perianal magnetic resonance imaging(MRI).Methods This was a retrospective analysis of clinical data from 421 patients with anal fistula surgically treated at the Department of Anorectal Diseases,Eastern Branch,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,between August 2016 and June 2018.All patients underwent perianal MRI before surgery.Among the 421 patients,64(15.2%)experienced recurrence.Anal sphincter-related parameters(thickness of internal and external sphincter,and the space be⁃tween internal and external sphincter)and anal fistula-related parameters(height of fistula and internal orifice)were compared be⁃tween patients who are cured and those who had recurrence.Results Compared with those cured,patients with recurrence had significantly greater space between internal and external sphincter on the bilateral sides and thicker internal sphincter(P<0.05).The space between the internal and external sphincter on anterior or posterior sides and the external sphincter thickness were comparable between the two groups(P>0.05).Patients who had recurrence had significantly greater fistula and internal orifice heights than those who were cured(P<0.05).Conclusion There were significant differences between anal fistula patients who were cured and patients who had recurrence in terms of fistula and internal orifice heights,the thickness of internal sphincter,and the space between the internal and external sphincter on the bilateral sides.These parameters might have influences on the recurrence of anal fistula.