CAJ | 학술논문

背景：治疗高位肛瘘的方法有瘘管剔除、切开挂线、选择性黏膜瓣推移、生物蛋白胶封堵、括约肌间瘘管结扎等，大都存在创面愈合间长、一次成功率较低、复发率偏高的不足，术后并发症发生率高。 　　目的：观察应用脱细胞异体真皮基质治疗高位肛瘘的临床疗效，探讨治疗高位肛瘘的微创治疗新方法。 　　方法：选择100例高位肛瘘患者，根据患者意愿分2组治疗，治疗组采用脱细胞异体真皮基质填塞治疗，对照组采用传统的肛瘘低位切开并高位挂线治疗，比较两组手术时间、术中出血量、术后目测类比评分、术后疼痛持续时间、肛门失禁严重程度评分、创面愈合时间、一期手术成功率、治愈率及复发率。 　　结果与结论：治疗组手术时间、术中出血量、创面愈合时间、术后目测类比评分、术后疼痛持续时间、肛门失禁严重程度评分均低于对照组(P <0.05)，一期手术成功率及治愈率高于对照组(P <0.05)，两组复发率比较差异无显著性意义。表明脱细胞异体真皮基质填塞修复高位肛瘘具有创伤小、恢复快、疗程短、治愈率高和不损害肛门功能及外观的优点。
배경：치료고위항루적방법유루관척제、절개괘선、선택성점막판추이、생물단백효봉도、괄약기간루관결찰등，대도존재창면유합간장、일차성공솔교저、복발솔편고적불족，술후병발증발생솔고。 　　목적：관찰응용탈세포이체진피기질치료고위항루적림상료효，탐토치료고위항루적미창치료신방법。 　　방법：선택100례고위항루환자，근거환자의원분2조치료，치료조채용탈세포이체진피기질전새치료，대조조채용전통적항루저위절개병고위괘선치료，비교량조수술시간、술중출혈량、술후목측류비평분、술후동통지속시간、항문실금엄중정도평분、창면유합시간、일기수술성공솔、치유솔급복발솔。 　　결과여결론：치료조수술시간、술중출혈량、창면유합시간、술후목측류비평분、술후동통지속시간、항문실금엄중정도평분균저우대조조(P <0.05)，일기수술성공솔급치유솔고우대조조(P <0.05)，량조복발솔비교차이무현저성의의。표명탈세포이체진피기질전새수복고위항루구유창상소、회복쾌、료정단、치유솔고화불손해항문공능급외관적우점。
BACKGROUND:Treatment methods for high anal fistula include fistula removal, incision and thread drawing, selective mucosal flap displacement, fibrin glue closure, fistula liagtion between sphincter, most of which show many advantages, including long-term healing, a low success rate, high recurrence rate, and high postoperative complication rate. OBJECTIVE:To observe the clinical effect of acelular extracelular matrix in the treatment of high anal fistula, and to explore a minimaly invasive treatment for high anal fistula. METHODS: Totaly 100 cases of high anal fistula were randomly divided into treatment group and control group, 50 cases in each group. Treatment group were treated with alogenic acelular extracelular matrix, and control group were treated with traditional low incision with high thread-drawing. Then, we observed and compared the operation time, bleeding volume, postoperative pain score (visual analog scale score), postoperative pain duration, anal incontinence severity score (Wexner score), wound healing time, one-stage success rate, cure rate, recurrence rate. RESULTS AND CONCLUSION: Compared with the control group, the treatment group showed lower scores in the operation time, bleeding volume, wound healing time, visual analog scale score, postoperative pain duration, and anal incontinence severity score (P < 0.05), but higher scores in one-stage success rate and cure rate (P < 0.05). There was no difference in the recurrence rate between the two groups. These findings indicate that the alogenic acelular extracelular matrix for treatment of high anal fistula exhibits smal trauma, quick recovery, short course of treatment, high cure rate and has no damage to the anal function and appearance.