腔内超声在肛周脓肿诊疗中的应用价值

Value of Intracavitary Ultrasound in Diagnosis and Treatment of Perianal Abscess

目的探讨腔内超声在肛周脓肿诊疗中的应用价值,为临床手术方式的选择提供更有效的依据。方法选取肛周脓肿患者100例,根据患者意愿,将术前未接受腔内超声检查者归为对照组(n=50),术前接受腔内超声检查归为观察组(n=50)。对照组行视诊、触诊、直肠指诊、肛门内镜等常规检查,根据临床表现及术者经验进行手术。观察组在常规检查基础上行腔内超声诊断定位,手术医生参照超声所见结合临床经验再行手术切开引流。以手术医师术中诊断为“金标准”,比较2组多发脓肿诊断准确率、内口检出率、总诊断准确率、伤口愈合时间以及总有效率、生活质量水平,观察是否有后遗肛瘘或复发。结果观察组对多发脓肿的诊断、内口的识别以及潜在瘘管判断准确度均高于对照组(P<0.05);总有效率高于对照组,伤口愈合时间短于对照组(P<0.05);2组生活质量水平比较差异无统计学意义(P>0.05)。结论腔内超声对肛周脓肿的正确诊断、病灶定位具有独特优势,同时能增加内口检出率及潜在瘘管显示率,进而为临床术式的选择提供依据。

Objective To explore the value of intracavitary ultrasound in the diagnosis and treatment of perianal abscess,and to provide a more effective basis for the selection of surgical methods for perianal abscess.Methods According to the patients’willingness,100 patients with perianal abscess were divided into two groups,with 50 patients in each group.The control group received routine examinations such as visual examination,palpation,digital rectal examination and anal endoscopy,and underwent surgery based on clinical manifestations and surgeon’s experience.The observation group received intracavitary ultrasound diagnosis and localization based on routine examinations,and the surgeon performed incision and drainage according to the ultrasound findings and clinical experience.The intraoperative diagnosis of the surgeon was used as the gold standard to compare the diagnostic accuracy of multiple abscesses,detection rate of internal orifice,overall diagnostic accuracy,wound healing time,quality of life,posterior anal fistula and recurrence between the two groups.Results The accuracies of diagnosis of multiple abscesses,identification of internal orifice and determination of potential fistula in the observation group were higher than those in the control group(P<0.05).The total effective rate in the observation group was higher than that in the control group,and the wound healing time in the observation group was shorter than that in the control group(P<0.05).There was no significant difference in the quality of life between the two groups(P>0.05).Conclusion Intracavitary ultrasound has unique advantages for the diagnosis and localization of perianal abscess.It can increase the detection rate of internal orifice and the display rate of potential fistula,thereby providing the basis for the selection of clinical operation.