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Perianal disease in inflammatory bowel disease:Broadening treatment and surveillance strategies for anal cancer 被引量:3
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作者 Tatiana Pacheco Sara Monteiro +1 位作者 Luísa Barros Jorge Silva 《World Journal of Gastroenterology》 SCIE CAS 2024年第28期3373-3385,共13页
The perianal disease affects up to one-third of individuals with Crohn's disease(CD),causing disabling symptoms and significant impairment in quality of life,particularly for those with perianal fistulising CD(PFC... The perianal disease affects up to one-third of individuals with Crohn's disease(CD),causing disabling symptoms and significant impairment in quality of life,particularly for those with perianal fistulising CD(PFCD).The collaborative effort between gastroenterologists and surgeons is essential for addressing PFCD to achieve fistula closure and promote luminal healing.Limited fistula healing rates with conventional therapies have prompted the emergence of new biological agents,endoscopic procedures and surgical techniques that show promising results.Among these,mesenchymal stem cells injection is a particularly hopeful therapy.In addition to the burden of fistulas,individuals with perianal CD may face an increased risk of developing anal cancer.This underscores the importance of surveillance programmes and timely interventions to prevent late diagnoses and poor outcomes.Currently,there is no established formal anal screening programme.In this review,we provide an overview of the current state of the art in managing PFCD,including novel medical,endoscopic and surgical approaches.The discussion also focuses on the relevance of establishing an anal cancer screening programme in CD,intending to propose a risk-based surveillance algorithm.The validation of this surveillance programme would be a significant step forward in improving patient care and outcomes. 展开更多
关键词 Inflammatory bowel disease Crohn's disease perianal FISTULA Anus diseases Management anal cancer SCREENING
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A case study illustrating the use of an integrated approach to treat secondary Anal Fistula Post I&D of Perianal Abscess
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作者 Sandeep Kumar Upadhyay Sheetal Asutkar Shreya Soni 《Clinical Research Communications》 2024年第1期11-17,共7页
Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pu... Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach. 展开更多
关键词 anal fistula COLONOSCOPY ligation of trans-sphincteric fistula Methylene blue dye perianal abscess Radical excision Sushrut Samhita
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Transcutaneous perianal sonography:A sensitive method for the detection of perianal inflammatory lesions in Crohn's disease 被引量:8
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作者 Jochen Wedemeyer Timm Kirchhoff +6 位作者 Gernot Sellge Oliver Bachmann Joachim Lotz Michael Galanski Michael P.Manns Michael J.Gebel Jrg S.Bleck 《World Journal of Gastroenterology》 SCIE CAS CSCD 2004年第19期2859-2863,共5页
AIM:Pelvic magnetic resonance imaging(MRI)and endoanal ultrasound which are established imaging methods for perianal inflammatory lesions in patients with Crohn's disease require expensive specialized equipments a... AIM:Pelvic magnetic resonance imaging(MRI)and endoanal ultrasound which are established imaging methods for perianal inflammatory lesions in patients with Crohn's disease require expensive specialized equipments and expertise.We investigated the feasibility and sensitivity of transcutaneous perianal ultrasound(PAUS)using regular ultrasound probes in the imaging of perianal inflammatory lesions.The sonographic findings were correlated to pelvic MR]-scans. METHODS:We performed PAUS in 25 patients with Crohn's disease and clinical signs of perianal inflammatory disease. Wibhin a median of 10 d(range 0-75)these patients underwent MRI of the pelvis.Regular convex and linear high resolution probes were used for PAUS.The sonographic findings were correlated to the MRI findings by blinded investigators. RESULTS:The sonographic investigations were well tolerated by all patients.Fistulae typically presented as hypoechoic tracks.Twenty-nine fistulae were detected in 22 patients.Abscesses were detected in 7 patients and presented as hypo-or anechoic formations.Twenty-six of 29 fistulae and 6 of 7 abscesses could be confirmed by MRI.Kappa statistics showed an excellent agreement (kappa>0.83)between the two imaging methods. CONCLUSION:PAUS is a simple,painless,feasible,real- time method that can be performed without specific patient preparation which is comparable in its sensitivity to pelvic MRI in the detection of perianal fistulae and/or abscesses. PAUS can especially be recommended as a screening tool in acute perianal disorders such as perianal abscess and for follow-up studies of perianal inflammatory disease. 展开更多
关键词 anal canal HISTOLOGY Anus Diseases Crohn Disease Humans Inflammation Ultrasonography Doppler Color
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Establishment of a surveillance program for anal cancer in Crohn's disease
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作者 Hajime Kayano Ken-Ichi Okada +1 位作者 Seiichiro Yamamoto Kazuo Koyanagi 《World Journal of Gastroenterology》 SCIE CAS 2024年第45期4844-4849,共6页
This letter discusses the incidence of anal cancer among Crohn's disease(CD)-related malignancies.Patients with CD have been demonstrated to be at a higher risk of developing small bowel and colorectal cancers tha... This letter discusses the incidence of anal cancer among Crohn's disease(CD)-related malignancies.Patients with CD have been demonstrated to be at a higher risk of developing small bowel and colorectal cancers than healthy individuals.Although CD-associated anal cancer is relatively rare,patients with CD accom-panied by anal or perianal lesions are at increased risk of anal cancer.Addi-tionally,compared to ulcerative colitis,which is also an inflammatory disease,CD-related anal cancer is often detected at an advanced stage owing to the complexity of CD and is associated with a poor prognosis with frequent local recurrences.Therefore,the detection of early-stage cancer is crucial for improving the prognosis.However,the surveillance methods recommended for CD-related malignancies in the United States and Europe are similar to those for ulcerative colitis.They are not appropriate for detecting CD-related malignancies in the recto-anal region.Therefore,there is an urgent need for surveillance programs aimed at the early detection of malignant anorectal lesions in patients with CD. 展开更多
关键词 Inflammatory bowel disease Crohn's disease Colorectal cancer perianal disease anal cancer surveillance
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High complex anal fistula managed by the modified transanal opening of the intersphincteric space via the inter-sphincteric approach:A case report
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作者 Ya-Qun Wang Yan Wang +2 位作者 Xiao-Feng Jia Qiao-Jing Yan Xue-Ping Zheng 《World Journal of Radiology》 2024年第10期552-560,共9页
BACKGROUND High complex anal fistulas are epithelialized tunnels,with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line.Conventional surgical procedures ... BACKGROUND High complex anal fistulas are epithelialized tunnels,with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line.Conventional surgical procedures for high complex anal fistulas remove most of the external sphincter and damage the anorectal ring.Postoperative loss of anal function can cause physical and mental damage.Transanal opening of the intersphincteric space(TROPIS)is an effective procedure that completely preserves the external anal sphincter.However,its clinical application is limited by challenges in the localization of the internal opening of a fistula and the high risk of complications.On the basis of our clinical experience,we modified the TROPIS procedure for the treatment of treating high complex anal fistulas.CASE SUMMARY A patient with a high complex anal fistula located above the anorectal ring underwent modified TROPIS,which involved sepsis drainage and identification of the internal opening in the intersphincteric space.The patient with the high complex anal fistula recovered well postoperatively,without any postoperative complications or anal dysfunction.Anal function returned to normal after 17 months of follow-up.CONCLUSION The modified TROPIS procedure is the most minimally invasive surgery for anal fistulas that minimally impairs anal function.It allows the complete removal of infected anal glands and reduces the risk of postoperative complications.Modified TROPIS via the intersphincteric approach is an alternative sphincter-preserving treatment for high complex anal fistulas. 展开更多
关键词 High complex anal fistula Inter-sphincteric infection Trans-anal opening of inter-sphincteric space perianal Pelvic magnetic resonance imaging anal function protection Case report
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Infiltrating adenocarcinoma arising in a villous adenoma of the anal canal 被引量:2
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作者 Marni Colvin Aris Delis +2 位作者 Erika Bracamonte Hugo Villar Luis R Leon Jr 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第28期3560-3564,共5页
Primary neoplasms arising in the anal canal are relatively unusual.In particular, adenomas and adenocarcinomas are distinctly rare entities in this region.We describe an infiltrating, well-differentiated adenocarcinom... Primary neoplasms arising in the anal canal are relatively unusual.In particular, adenomas and adenocarcinomas are distinctly rare entities in this region.We describe an infiltrating, well-differentiated adenocarcinoma arising in a villous adenoma from the distal anal canal, in an otherwise healthy patient at low risk for gastrointestinal malignancy.This is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous hematochezia.Examination revealed a blood-covered pedunculated mass with a long stalk protruding from the anus.The lesion was amputated at the bedside.Microscopic evaluation revealed an infiltrating well-differentiated adenocarcinoma, arising from a villous adenoma.This was further evaluated under anesthesia and complete excision of distal anal tissue was performed.Our report is the f irst describing the possible malignant degeneration of a villous adenoma in the anal canal. 展开更多
关键词 anal adenocarcinoma anal canal Villousadenoma
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Anal canal gastrointestinal stromal tumors:Case report and literature review 被引量:1
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作者 Nuno Carvalho Diogo Albergaria +4 位作者 Rui Lebre Joo Giria Vitor Fernandes Helena Vidal Maria José Brito 《World Journal of Gastroenterology》 SCIE CAS 2014年第1期319-322,共4页
Gastrointestinal stromal tumors (GIST) are an uncommon group of tumors of mesenchymal origin. GIST of the anal canal is extremely rare. At present, only 10 cases of c-kit positive anal GIST have been reported in the l... Gastrointestinal stromal tumors (GIST) are an uncommon group of tumors of mesenchymal origin. GIST of the anal canal is extremely rare. At present, only 10 cases of c-kit positive anal GIST have been reported in the literature. There is no widely accepted treatment approach for this neoplasia. Literature is sparse on imaging evaluation of anal canal GIST, usually described as a lesion in the intersphincteric space. We describe the case of a 73-year-old man with a mass in the anal canal, and no other symptoms. Endoanal ultrasound and magnetic resonance imaging showed a well circumscribed solid nodule in the intersphincteric space. The patient was treated by local excision. Gross pathological examination showed a 7 cm &#x000d7; 3.5 cm &#x000d7; 3 cm mass, and histological examination showed a proliferation of spindle cells, with prominent nuclear palisading. The mitotic count was of 12 mitoses/50 HPF. The tumor was positive for KIT protein, CD34 and vimentin in the majority of cells, and negative for desmin and S100. A diagnosis of GIST, with high risk aggressive behavior was made. An abdomino-perineal resection was discussed, but refused. The follow-up included clinical evaluation and anal ultrasound. After 5 years the patient is well, with maintained continence and no evidence of local recurrence. 展开更多
关键词 Gastrointestinal stromal tumors anal canal Endoanal ultrasound Magnetic resonance imaging C-Kit receptor Local excision
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Tubulovillous adenoma of anal canal: A case report 被引量:1
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作者 Bhupinder S Anand Gordana Verstovsek George Cole 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第11期1780-1781,共2页
Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare di... Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery. Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma. 展开更多
关键词 Tubulovillous adenoma anal canal
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Cloacogenic carcinoma of anal canal:two case reports and review of Chinese literature 被引量:1
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作者 Shaoliang Han Sheqing Ji +1 位作者 Shengcong Guo Wangyong Li 《The Chinese-German Journal of Clinical Oncology》 CAS 2010年第5期302-304,共3页
Cloacogenic carcinoma is a rare tumor of rectum and anus,which originating from epithelium of the anal transition zone of embryonic residuals.We described the medical history of two patients with cloacogenic carcinoma... Cloacogenic carcinoma is a rare tumor of rectum and anus,which originating from epithelium of the anal transition zone of embryonic residuals.We described the medical history of two patients with cloacogenic carcinoma of anal canal and reviewed of the Chinese literature(January 1994 to March 2009).In conclusion,cloacogenic carcinoma of anal canal can obtain good results with a abdominoperineal excision(APE). 展开更多
关键词 anal canal basaloid squamous cancer cloacogenic carcinoma
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基于MRI的健康成年女性肛门括约肌复合体有限元模型
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作者 余求祥 郑丽华 陈正光 《中国医学影像技术》 CSCD 北大核心 2024年第7期1083-1086,共4页
目的观察基于MRI建立的健康成年女性肛门括约肌复合体(ASC)有限元模型的仿真性。方法前瞻性纳入1名健康成年女性,采用Mimics三维重建软件基于其肛管MRI构建ASC几何模型并将其有限元网格化;参考肛门括约肌离体实验参数及正常人肛门直肠... 目的观察基于MRI建立的健康成年女性肛门括约肌复合体(ASC)有限元模型的仿真性。方法前瞻性纳入1名健康成年女性,采用Mimics三维重建软件基于其肛管MRI构建ASC几何模型并将其有限元网格化;参考肛门括约肌离体实验参数及正常人肛门直肠压力数据建立有限元模型,分析其生理特征及应力分布。结果对ASC有限元模型施加边界载荷后,静息态下肛门外括约肌出现收缩形变,肛管最大位移为0.02 mm,肛门内括约肌最大位移更小,且肛管上部内表面正前方存在明显低应力区;力排状态下肛管出现较大扩张形变,肛门内括约肌内表面最大位移为4.16 mm;收缩状态下肛管被挤压,肛门内括约肌内表面最大位移为1.89 mm;静息态及收缩状态下肛门内、外括约肌整体均向正前方移动。结论所获ASC有限元模型可在一定程度上模拟女性实际肌肉群生理活动及其应力分布。 展开更多
关键词 肛管 磁共振成像 括约肌 耻骨直肠肌 三维有限元
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疮愈膏外敷促进湿热蕴结证肛周脓肿术后创面愈合临床研究
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作者 张新春 刘佃温 +1 位作者 杨会举 刘红敏 《新中医》 CAS 2024年第18期88-92,共5页
目的:观察疮愈膏外敷对湿热蕴结证肛周脓肿术后创面愈合的促进作用。方法:将70例湿热蕴结证肛周脓肿患者按随机数字表法分为治疗组和对照组,每组35例。在术后常规换药基础上,治疗组给予疮愈膏外敷创面治疗,对照组则给予凡士林纱条外敷... 目的:观察疮愈膏外敷对湿热蕴结证肛周脓肿术后创面愈合的促进作用。方法:将70例湿热蕴结证肛周脓肿患者按随机数字表法分为治疗组和对照组,每组35例。在术后常规换药基础上,治疗组给予疮愈膏外敷创面治疗,对照组则给予凡士林纱条外敷创面治疗。比较2组临床疗效、创面愈合时间、疼痛评分、创面分泌物评分、肛门功能指标及血清炎症指标水平。结果:治疗2周后,治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗组创面愈合时间短于对照组,差异有统计学意义(P<0.05)。治疗2周后,2组疼痛、创面分泌物评分均较术后第2天降低,治疗组疼痛、创面分泌物评分均低于对照组,差异均有统计学意义(P<0.05)。治疗2周后,2组肛管静息压、肛管最大收缩压均较术前降低,治疗组肛管静息压、肛管最大收缩压均低于对照组,差异均有统计学意义(P<0.05)。治疗2周后,2组血清C-反应蛋白(CRP)、白细胞介素-6 (IL-6)及肿瘤坏死因子-α (TNF-α)水平均较术后第2天降低,治疗组血清CRP、IL-6及TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。结论:疮愈膏外敷可有效改善肛周脓肿湿热蕴结证术后患者的临床症状,降低炎症指标水平,改善肛门功能,促进创面愈合。 展开更多
关键词 肛周脓肿 湿热蕴结证 疮愈膏 外敷 炎症指标 创面愈合 肛门功能
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婴幼儿肛周脓肿和肛瘘的发病机制及治疗的研究进展
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作者 张晓静 朱勇 《医药前沿》 2024年第11期34-36,共3页
肛周脓肿和肛瘘是婴幼儿两种常见的肛周疾病。目前对其发病机制、临床诊断和治疗仍存在争议。本文总结了婴幼儿肛周脓肿和肛瘘的发病机制、临床表现和治疗等方面的研究进展,旨在为临床医师诊治此类疾病时提供理论支持。
关键词 综述 肛周脓肿 肛瘘 婴幼儿
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超声引导下腘窝坐骨神经联合收肌管阻滞用于膝关节置换手术镇痛的效果评价
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作者 张杰 钱彦 《海南医学》 CAS 2024年第15期2180-2184,共5页
目的评价超声引导下腘窝坐骨神经联合收肌管阻滞用于膝关节置换手术镇痛的临床效果。方法选取2020年1月至2023年7月在湖州市南浔区人民医院择期行单侧膝关节置换手术的60例患者纳入研究,按随机数表法分为A组和B组,每组30例。A组患者全... 目的评价超声引导下腘窝坐骨神经联合收肌管阻滞用于膝关节置换手术镇痛的临床效果。方法选取2020年1月至2023年7月在湖州市南浔区人民医院择期行单侧膝关节置换手术的60例患者纳入研究,按随机数表法分为A组和B组,每组30例。A组患者全麻前超声引导下行腘窝坐骨神经阻滞,B组患者全麻前超声引导下行腘窝坐骨神经联合收肌管阻滞;两组患者均行术后静脉镇痛。比较两组患者的感觉阻滞起效时间及维持时间、运动阻滞起效时间及维持时间、麻醉诱导前、手术切皮时和手术结束时的血流动力学;同时比较两组患者术后4 h、8 h、24 h和36 h的视觉模拟评分(VAS),以及术后36 h内的镇痛泵首次按压时间和镇痛泵有效按压次数。结果B组患者的感觉阻滞起效时间为(11.88±0.27)min,明显短于A组的(14.1±10.22)min,感觉阻滞维持时间为(747.00±23.08)min,明显长于A组的(571.90±17.98)min,差异均有统计学意义(P<0.05);但两组的运动阻滞起效时间和运动阻滞维持时间比较差异均无统计学意义(P>0.05);B组患者在手术切皮时、手术结束时的心率分别为(69.38±5.2)次/min、(66.79±4.73)次/min,明显低于A组的(72.97±5.2)次/min、(69.40±5.06)次/min,而平均动脉压分别为(92.91±8.08)mm Hg、(94.67±8.69)mm Hg,明显高于A组的(89.29±7.58)mmHg、(86.70±7.28)mmHg,差异均有统计学意义(P<0.05);术后8 h、24 h、36 h,B组患者的VAS评分分别为(4.12±0.06)分、(3.42±0.12)分、(2.44±0.10)分,明显低于A组的(4.87±0.15)分、(4.61±0.09)分、(3.47±0.16)分,差异均有统计学意义(P<0.05);术后36 h内,B组患者的静脉自控镇痛泵首次按压时间为(306.8±0.90)min,明显长于A组的(177.3±1.47)min,差异均有统计学意义(P<0.05);术后24 h、36 h,B组患者镇痛泵有效按压次数分别为(1.35±0.04)次、(2.55±0.09)次,明显少于A组的(1.66±0.05)次、(3.48±0.09)次,差异均有统计学意义(P<0.05)。结论超声引导下腘窝坐骨神经联合收肌管阻滞能提升膝关节置换手术患者的麻醉效率,维持血流动力学稳定,同时确保围手术期镇痛效果,使术后自控镇痛应用频率降低。 展开更多
关键词 超声引导 膝关节置换手术 腘窝坐骨神经 收肌管阻滞 镇痛
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难治性克罗恩病肛瘘合并严重感染的成功管理经验总结(1例报告)
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作者 阮剑敏 李永洁 +1 位作者 林洁梅 刘莉 《岭南现代临床外科》 2024年第3期199-205,共7页
目的总结1例克罗恩病肛瘘合并肛周脓肿的重症患者的治疗与护理经验。方法回顾性分析中山大学孙逸仙纪念医院消化内科收治1例克罗恩病肛瘘合并肛周脓肿患者的临床治疗资料。结果患者经内科治疗与护理65天后情况好转出院。结论克罗恩病合... 目的总结1例克罗恩病肛瘘合并肛周脓肿的重症患者的治疗与护理经验。方法回顾性分析中山大学孙逸仙纪念医院消化内科收治1例克罗恩病肛瘘合并肛周脓肿患者的临床治疗资料。结果患者经内科治疗与护理65天后情况好转出院。结论克罗恩病合并肛瘘、肛周脓肿,临床治疗棘手,治疗成功的关键在于多学科联合治疗及个体化管理措施。 展开更多
关键词 克罗恩病 肛瘘 肛周脓肿 肛瘘冲洗
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经肛门直肠黏膜瓣推移术与经肛括约肌间切开术治疗复杂性肛瘘的效果及对肛管直肠压力的影响 被引量:4
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作者 熊健 谢华辉 +5 位作者 何文涛 李明堃 沈明 张仁浩 牛天峰 罗靖 《临床外科杂志》 2024年第1期62-66,共5页
目的 探讨经肛门直肠黏膜瓣推移术(endoanal advancement flap,ERAF)与经肛括约肌间切开术(transanal opening of intersphincteric space,TROPIS)治疗复杂性肛瘘的效果及对肛管直肠压力的影响。方法 2018年10月~2022年10月收治的复杂... 目的 探讨经肛门直肠黏膜瓣推移术(endoanal advancement flap,ERAF)与经肛括约肌间切开术(transanal opening of intersphincteric space,TROPIS)治疗复杂性肛瘘的效果及对肛管直肠压力的影响。方法 2018年10月~2022年10月收治的复杂性肛瘘病人84例,按治疗方法分为ERAF治疗组(E组,48例)和TROPIS治疗组(T组,36例)。比较两组临床疗效、手术情况、创面情况以及肛管直肠压力。结果 T组治疗有效率为97.22%,高于E组的87.50%,但差异无统计学意义(P>0.05)。T组手术时间为(31.53±7.29)分钟,术中出血量为(29.56±7.37)ml,手术当天、术后7天和14天创面面积分别为(10.03±0.96)cm~2、(8.76±0.87)cm~2和(6.20±0.77)cm~2,E组分别为(35.36±8.54)分钟、(36.86±8.04)ml、(12.09±1.23)cm~2、(10.52±1.09)cm~2和(7.36±0.85)cm~2,两组比较差异有统计学意义(P<0.05)。T组术后VAS评分、Wexner失禁评分分别为(1.38±0.27)分和(0.21±0.08)分,E组分别为(1.56±0.29)分和(0.33±0.09)分,T组20 mm处、30 mm处肛管直肠收缩压和20 mm处、30 mm处肛管直肠静息压分别为(138.18±29.58)mmHg、(136.22±35.41)mmHg、(35.47±6.58)mmHg和(32.97±8.01)mmHg,E组分别为(152.78±31.53)mmHg、(156.29±32.74)mmHg、(38.29±7.62)mmHg、(36.41±7.63)mmHg,两组评分和肛管直肠压力均下降,且T组低于E组,两组比较差异有统计学意义(P<0.05)。E组不良反应发生率(20.83%)高于F组的(13.89%),但差异无统计学意义(P>0.05)。结论 TROPIS治疗复杂性肛瘘的效果更好,能缩减手术时间,减少术中出血量,减轻术后疼痛,保护肛门功能。 展开更多
关键词 经肛门直肠黏膜瓣推移术 经肛括约肌间切开术 复杂性肛瘘 直肠 肛管
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中药熏洗联合肛瘘挂线治疗肛瘘合并肛周脓肿患儿的应用效果 被引量:2
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作者 舒芳 吴书清 +2 位作者 曾珊 卢君 钟斌 《中国当代医药》 CAS 2024年第16期77-81,共5页
目的探讨中药熏洗联合肛瘘挂线治疗肛瘘合并肛周脓肿患儿的应用效果。方法选取2021年6月至2023年6月赣州市妇幼保健院收治的70例肛瘘合并肛周脓肿患儿作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各35例,对照组采用肛瘘... 目的探讨中药熏洗联合肛瘘挂线治疗肛瘘合并肛周脓肿患儿的应用效果。方法选取2021年6月至2023年6月赣州市妇幼保健院收治的70例肛瘘合并肛周脓肿患儿作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各35例,对照组采用肛瘘挂线联合高锰酸钾溶液坐浴治疗,观察组采用肛瘘挂线联合中药熏洗治疗。比较两组患儿的黏膜愈合时间、创面完全愈合时间、住院时间、疼痛评分、肛周自控能力评分、中医证候积分、肛门功能、疗效、肛周脓肿及肛瘘复发率。结果观察组的黏膜愈合、创面完全愈合及住院时间均短于对照组,差异有统计学意义(P<0.05);观察组的疼痛及肛周自控能力评分均低于对照组,差异有统计学意义(P<0.05);观察组的肛周肿痛、便时剧痛及大便秘结积分均低于对照组,差异有统计学意义(P<0.05);观察组的肛门功能恢复优于对照组,总有效率(91.43%)高于对照组(71.43%),肛瘘复发率(8.57%)、肛周脓肿复发率(5.71%)均低于对照组(40.00%、31.43%),差异有统计学意义(P<0.05)。结论经中药熏洗联合肛瘘挂线治疗可有效促进肛瘘创面愈合,预防肛周脓肿及肛瘘复发,减轻患儿疼痛,促使肛门功能恢复,缩短住院时间,促进其病情转归,其效果确切,值得推广。 展开更多
关键词 中药熏洗 肛瘘挂线 肛瘘 肛周脓肿 中医证候积分 疗效
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马应龙麝香痔疮膏对肛周脓肿术后患者症状控制、肛门功能及Col-Ⅰ、TGF-β1、VEGF、EGF水平的影响 被引量:1
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作者 曾子荣 陆正明 +1 位作者 罗祖平 庞启明 《临床误诊误治》 CAS 2024年第7期85-90,共6页
目的探讨马应龙麝香痔疮膏对肛周脓肿术后患者症状控制、肛门功能及胶原蛋白-Ⅰ(Col-Ⅰ)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)、表皮生长因子(EGF)水平的影响。方法选择2020年4月—2023年4月收治的122例肛周脓肿术后患... 目的探讨马应龙麝香痔疮膏对肛周脓肿术后患者症状控制、肛门功能及胶原蛋白-Ⅰ(Col-Ⅰ)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)、表皮生长因子(EGF)水平的影响。方法选择2020年4月—2023年4月收治的122例肛周脓肿术后患者,按随机数字表法分为对照组和观察组各61例。对照组给予生理盐水清创,观察组在对照组基础上联合马应龙麝香痔疮膏治疗。2组均治疗3周,随访6个月。统计2组术后3周临床疗效及治疗期间不良反应发生情况,比较2组术后1 d和术后3周症状控制情况、创面组织细胞因子表达情况、血清炎性因子水平及术前、术后6个月肛门功能。结果术后3周,观察组总有效率[91.80%(56/61)]高于对照组[78.69%(48/61)](P<0.05)。观察组术后3周创面水肿、创面分泌物、肉芽组织及疼痛评分,血清白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平及术后6个月直肠静息压、肛管静息压、肛管最大收缩压、Wexner肛门失禁评分低于对照组,创面组织Col-Ⅰ、TGF-β1、VEGF、EGF表达水平高于对照组(P<0.01)。观察组治疗期间总不良反应发生率[4.92%(3/61)]与对照组[1.64%(1/61)]比较差异无统计学意义(P>0.05)。结论肛周脓肿术后应用马应龙麝香痔疮膏治疗可有效改善创面组织细胞因子表达水平,减轻机体炎症反应,促进创面愈合,有助于患者症状控制,促进肛门功能转归,具有较好的治疗效果,同时安全性良好。 展开更多
关键词 肛周脓肿 马应龙麝香痔疮膏 转化生长因子-β1 血管内皮生长因子 表皮生长因子 直肠静息压 肛管静息压 肛管最大收缩压
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腕踝针联合中药熏蒸对混合痔患者术后肛周水肿及肛门功能的影响 被引量:1
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作者 庄映如 黄少鹏 李焕容 《上海针灸杂志》 CSCD 2024年第3期312-317,共6页
目的 观察腕踝针联合中药熏蒸对混合痔术患者术后肛周水肿及肛门功能的影响。方法 将83例行混合痔手术的患者随机分为熏蒸组(28例)、腕踝针组(25例)和联合组(30例)。3组均采用常规治疗,熏蒸组采用四妙散熏蒸治疗,腕踝针组进行腕踝针治疗... 目的 观察腕踝针联合中药熏蒸对混合痔术患者术后肛周水肿及肛门功能的影响。方法 将83例行混合痔手术的患者随机分为熏蒸组(28例)、腕踝针组(25例)和联合组(30例)。3组均采用常规治疗,熏蒸组采用四妙散熏蒸治疗,腕踝针组进行腕踝针治疗,联合组采用腕踝针联合四妙散熏蒸治疗。观察3组治疗前后便秘症状评分(粪便性状、排便困难和排便时间评分)、肛肠动力学指标[直肠静息压(rectal resting pressure,RRP)、肛管静息压(anal resting pressure, ARP)和肛管最大收缩压(anal maximal contraction pressure,AMCP)]、肛周水肿评分、视觉模拟量表(visual analog scale, VAS)评分和肛门功能评分(排气、稀便、黏液和干便评分),并比较3组临床疗效。结果 与治疗前比较,3组治疗后便秘症状评分、肛周水肿评分、VAS评分和肛门功能评分降低,肛肠动力学指标升高(P<0.05);联合组上述指标优于熏蒸组和腕踝针组(P<0.05)。联合组总有效率为93.3%,高于熏蒸组的78.6%和腕踝针组的72.0%(P<0.05);熏蒸组和腕踝针组总有效率比较,差异无统计学意义(P>0.05)。结论 在常规治疗的基础上,腕踝针联合四妙散熏蒸治疗,可降低混合痔患者术后肛周水肿程度,并改善患者肛门功能,减轻患者疼痛程度。 展开更多
关键词 针刺疗法 腕踝针 手术后并发症 熏洗 肛周水肿 肛门功能
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1997-2022年中医治疗肛周脓肿研究文献可视化分析
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作者 余丹琪 柳越冬 《中国中医药图书情报杂志》 2024年第1期177-182,共6页
目的 探索中医治疗肛周脓肿研究的发展趋势及近年研究热点。方法 检索1997年1月1日-2022年11月1日中国知识资源总库(CNKI)发表的中医治疗肛周脓肿文献。运用CiteSpace6.1.R2软件和文献计量学方法,绘制中医治疗肛周脓肿研究的作者、合作... 目的 探索中医治疗肛周脓肿研究的发展趋势及近年研究热点。方法 检索1997年1月1日-2022年11月1日中国知识资源总库(CNKI)发表的中医治疗肛周脓肿文献。运用CiteSpace6.1.R2软件和文献计量学方法,绘制中医治疗肛周脓肿研究的作者、合作机构、关键词聚类及突现词时间分布的科学知识图谱,梳理中医治疗肛周脓肿的研究热点与前沿方向。结果 纳入文献431篇,该领域的发文量经阶段性增加后趋于稳定。发文量最多的作者分别为令狐庆和贾慧玲,均为4篇;发文量最多的机构分别为南京中医药大学、成都中医药大学、辽宁中医药大学,均为4篇。关键词共现聚类网络主要涉及中药熏洗、中医疗法、术后恢复等。研究热点集中在病名、治疗手段、治疗药物、创口愈合观察指标等方面。结论 中药坐浴及综合护理对肛周脓肿术后创面愈合、肛门功能、术后疼痛的研究是近年持续的研究热点及研究趋势。 展开更多
关键词 中医药 肛周脓肿 肛痈 CITESPACE 知识图谱
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直肠肛管区特殊类型肿瘤的诊治进展
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作者 田红坤 杜雨强 +2 位作者 林曜 张鹏 陶凯雄 《临床外科杂志》 2024年第5期546-548,共3页
直肠肛管区存在诸如直肠神经内分泌肿瘤、胃肠间质瘤、肛管鳞癌、直肠肛管黑色素瘤、原发性直肠淋巴瘤等特殊类型肿瘤,其临床特征与直肠癌存在差异,且发病率较低,导致临床医师对其认识不足。本文对直肠肛管区特殊类型肿瘤的临床诊疗进... 直肠肛管区存在诸如直肠神经内分泌肿瘤、胃肠间质瘤、肛管鳞癌、直肠肛管黑色素瘤、原发性直肠淋巴瘤等特殊类型肿瘤,其临床特征与直肠癌存在差异,且发病率较低,导致临床医师对其认识不足。本文对直肠肛管区特殊类型肿瘤的临床诊疗进展进行综述。 展开更多
关键词 直肠神经内分泌肿瘤 胃肠间质瘤 肛管鳞癌 直肠肛管黑色素瘤 原发性直肠淋巴瘤
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