河南外科学杂志2011年3月第17卷第2期HENANJOURNALOFSURGERYMar.201l,Vo].17,No.2者龈沟液中IL一6的含量[J].华西医科大学学报,2001,32(3):444—445.[3]KawashimaH,SatoS,KishidaM,eta1.Acomparisonofrootsurfaceinstrumentationusingtwopiezoelectricultra-sonicsealersandahandscalerinvivo『J].JPeriodontalRes,2007,42(1):90—95.[4]LiuRK,CaoCF,MengHX,eta1.Polymorphonuclearneu-trophilsandtheirmediatorsingingivaltissuesfromgeneral一手术治疗358例肛瘘的临床分析李红樊平史伟季恩敏安徽亳州市人民医院肛肠外科亳州236800·9·izedaggressiveperiodontitis[J].JPeriodontol,2001,72(11):1545.[5]GafenSL,HajishengallisG.ANewInflammatoryCytokineontheBlock:Re—thingkingPeriodontalDiseaseandtheTh1/Th2ParadigmintheContextofThl7CellsandIL一17[J].DentRes,2008,87(9):817—828.(收稿2011—01~21)【摘要】目的探讨不同类型肛瘘的最佳治疗方法。方法回顾总结358例不同类型肛瘘的治疗过程,低位肛瘘一次切除,高位肛瘘低位切开,高位挂实线,窦道(支管)挂浮线;科学有效的术后治疗。结果一次手术治愈324例,一次手术治愈率90.5%;二次手术治愈34例,13例为第一次手术病灶切除不完全,21例为手术后换药不妥而假愈合。结论不同类型的肛瘘应采取不同的手术方式。一次切除病灶,正确处理内口,做好创口敞开引流,确保肛门功能,是一次手术治愈肛瘘的前提,手术后正确专科换药是治愈本病的重要环节。【关键词】肛瘘;手术【中图分类号】R657.16【文献标识码】A【文章编号】1007—8991(2011)02—0009~03Clinicalanalysisoncurativeeffectof358AnalFistulaOperationsLiHong,FanPing,ShiWei,JiEnmin.Depart.mentofColorectalSurgery,PeoplesHospitalofBozhouCity,Bozhou236800,China【Abstract】0bjectiveTostudythetreatmentofvarioustypesofanalfistula,toreducenumberofoperations,operationcompli—cationsandrecurrencerate.MethodsReviewed358casesofvarioustypesofanalfistulainclinic.resectioninone—stageforLowA—nalFistula,LowCuttingDrainageandHighThreadDrawingforHighAnalFistula,hangingfloatlineforbranchpipeofanalfistula,scientificandeficientmanagementwaysafteroperation.Results324cases(90.5%1werecuredupononeoperation.34easeswerecureduponsecondoperation.13casesoflesionexcisionincompletely.21casesoffalsewoundhealingbecauseofimproperlydressingchange.ConclusionCorrectoperativemethodishelpfultoensuretheoperation,lesionexcisionupononeoperation,correctlyhandlingtheinternalfistulalesions,ensurethefunctionofanal,areprerequisitetocureanalfistulaupononeoperation,properlydressingehan—gingafteroperationisanimportantlinktocureanalfistula.【KeyWords】Analfistula;Operation肛瘘是肛肠科的一种常见病,以外括约肌深部划线为标记,瘘管经过此线以上为高位,此线以下为低位,可分为低位单纯性肛瘘、低位复杂性肌瘘、高位单纯性肛瘘、高位复杂性肛痿(主管累及肛管直肠环以上、走行复杂弯曲、多支管或多内【_i的月T瘘)。2001—09~2010—09我院肛肠外科收治肛瘘患者358例,对不同类型的肛瘘,采取不同的外科治疗,现报告如下l资料与方法1.1一般资料本组358例,男l88例,女170例;年龄1~△通讯作者:樊平87岁,平均43岁,病程3个月~20a;低位单纯性肛瘘198例,低位复杂性肛瘘63例,高位单纯性肛瘘l9例,高位复杂性肛瘘78例。其中已做过肛瘘手术者25例。1.2方法I.2.1肛瘘切除术:适用于低位肛瘘。局麻或骶麻,常规消毒铺巾。右手持探针自外口探八,左手食指在肛管内做引导。探针自肛管内15引出,沿探针切开瘘管壁,切除创口内的瘘管组织,搔刮坏死组织,切除内口处肛窦及肛腺、肛门腺导管组织,修剪创口成V型,止血,修剪切缘。创口内·10·河南外科学杂志2011年3月第l7卷第2期HENANJOURNALOFSURGERYMar.2011,Vo1.17,No.2填塞油纱,外用...