CAJ | 학술논문

目的观察脱细胞真皮基质(acellular dermal matrix,ADM)生物材料治疗肛瘘的有效性和安全性.方法将102例肛瘘患者随机分成两组,每组51例,试验组采用ADM手术,对照组采用直肠黏膜瓣下移内口修补术,对两组患者的瘘管复发率、脓肿发生率、大便失禁率、肛门畸形率、术后疼痛时间、瘘管愈合时间等方面进行比较.采用卡方检验、秩和检验对数据进行分析.结果试验组瘘管成功闭合者43例(84%),复发3例(6%),脓肿发生1例(2%),术后大便失禁1例(2%).对照组瘘管成功闭合者29例(57%),复发13例(25%),脓肿发生5例(10%),术后大便失禁4例(8%).试验组瘘管复发率低于对照组(x2=7.413,P＜0.05),差异有统计学意义;疼痛时间、瘘管愈合时间等方面,试验组均优于对照组(U值分别为28.600,15.100,P＜0.05),差异有统计学意义.结论脱细胞真皮基质治疗肛瘘安全有效,可作为肛瘘的首选方法.
목적 관찰탈세포진피기질(acellular dermal matrix,ADM)생물재료치료항루적유효성화안전성.방법 장102례항루환자수궤분성량조,매조51례,시험조채용ADM수술,대조조채용직장점막판하이내구수보술,대량조환자적루관복발솔、농종발생솔、대편실금솔、항문기형솔、술후동통시간、루관유합시간등방면진행비교.채용잡방검험、질화검험대수거진행분석.결과 시험조루관성공폐합자43례(84%),복발3례(6%),농종발생1례(2%),술후대편실금1례(2%).대조조루관성공폐합자29례(57%),복발13례(25%),농종발생5례(10%),술후대편실금4례(8%).시험조루관복발솔저우대조조(x2=7.413,P＜0.05),차이유통계학의의;동통시간、루관유합시간등방면,시험조균우우대조조(U치분별위28.600,15.100,P＜0.05),차이유통계학의의.결론 탈세포진피기질치료항루안전유효,가작위항루적수선방법.
Objective To investigate the efficacy and safety of a bioabsorbable material acellular dermal matrix (ADM) for the treatments of anal fistula. Methods One hundred and two cases of anal fistula were divided into two groups for ADM and traditional treatment. Recurrence rate, infection rate, fecal incontinence rate, anorectal deformity rate, postoperative pain, closure time were compared with each other.Results Success rate in ADM group was 84% (43/51 ), fistulas (6%) recurred in 3 cases, one patient (2%) had abscess formation, one patient(2% ) had fecal incontinence. Success rate in controls was 57%(29/51), fistula recurred in 13 out of 51 (25%). Five patients (10%) were complicated with abscess formation, fecal incontinence in 4 cases. Fistula recurrence rate was significantly lower in ADM group than that in controls (x2 = 7. 413 ,P ＜ 0. 05 ). Pain lasting time and closure time in those with ADM are shorter than in controls ( U = 28. 600, 15. 100, P ＜ 0. 05 ). Conclusion ADM surgery is an effective and safe method for surgery of anal fistula.