经会阴及经阴道超声诊断对肛周不同来源性感染的意义

The Significance of Via Perineum or Via Vagina Ultrasound Inspection Diagnosing Perianal Infectious Diseases from Different Origins

目的:探讨经会阴及经阴道超声诊断对肛周不同来源性感染的意义。方法:选择可疑肛周疾病患者80例,男性采用经会阴超声诊断,女性采用经会阴超声结合经阴道超声诊断,详细检查所有脓肿、窦道及瘘管,非腺源性病变评估病变范围、可能性质,并将检查结果与手术结果进行对比分析。结果:1)80例手术患者中检出腺源性感染67例,非腺源性感染13例。2)67例腺源性感染患者肛瘘诊断结果:经术后确诊脓肿20例,主瘘管67例,支管18例,内口67例,外口67例。经超声诊断脓肿20例,符合率100%;主瘘管64例,符合率95.52%;支管15例,符合率83.33%;内口60例,符合率89.55%;外口67例,符合率100%。3)13例非腺源性感染病变中会阴尿道瘘、肛周表皮样囊肿、藏毛窦囊肿合并感染、肛周化脓性汗腺炎、血栓性外痔,均和手术病理检查结果相一致。结论:经会阴及经阴道超声在诊断肛周不同来源性感染中的价值显著,经会阴及阴道超声可进一步明确肛周腺源性炎症性疾病的范围及分型,通过鉴别腺源性感染、非腺源性感染类型为临床诊断提供重要参考价值,以便于及时开展治疗工作。

Objective To explore the significance of via perineum or via vagina ultrasound inspection diagnosing perianal infectious diseases from different orgins.Methods Enrolled 80patients with perianal diseases suspectied treated in author's hospital into this study in whom male patients received via perineum for ultrasound diagnosing,meanwhile,female,via vagina for doing so,detailed inspected their every abscess,sinus and syrinx,for non gland-origin lesion,and evaluated lesion range,possible nature;then,compared and analysed the attained results according to operative findings.Results 1)in the 80patients,gland-origin infection of 67cases,non-one of 13cases;2)in the 67cases,of gland-origin anal fistula,postoperatively confirmed in 20cases including main syrinx of 67cases,branch one of 18cases,inner-orifice of 67 cases,exterior-orifice of 67cases;20cases,of absces's were confirmed by ultrasound diagnosis,thus accordance rate was 100%;ultrasound diagnosis confirmed main syrinx of 64cases,accordance rate,95.52%;branch syrinx of 15cases,the rate of 83.33%;inner-orfice of 66cases,the rate of 89.55%;exterior-orifice of 67cases,the rate of 100%.3)in 13cases with non-gland origin in perineum-urethra fistula,perianal epidermal cyst,pilonidal cyst associated infection,perianal hidradenitis suppurativa,and thrombosed external hemorrhoids ultrasound inspection had the accordance results with operative pathological exam.one.Conclusion Both approaches for ultrasound diagnosis have significant value,all can further confirme the range and typies of gand-origin of perianal inflammation diseases.