CAJ | 학술논문

目的：评价经括约肌间瘘管结扎术治疗复杂性肛瘘的临床疗效。方法回顾性分析2009年9月至2012年2月间南京中医药大学附属医院肛肠科采用经括约肌间瘘管结扎术治疗的24例复杂性肛瘘患者的临床资料，评价手术疗效及患者术后肛门括约肌自主控制功能。结果一期手术治愈率为66．7％（16／24）。术后单纯括约肌间切口感染2例，经局部应用亲水性纤维含银敷料换药后愈合；4例括约肌间切口感染且内口与肛管内相通，经直接切开后愈合；完全失效2例，其中1例因术后症状持续而行挂线治疗，另1例术后7月复发。临床总治愈率为91．7％（22／24）。术后随访6～44（中位数16）月，克利夫兰肛门失禁评分结果显示，患者均无肛门括约肌自主控制功能下降。结论经括约肌间瘘管结扎术是一种治疗复杂性肛瘘安全有效的保留括约肌手术。
목적：평개경괄약기간루관결찰술치료복잡성항루적림상료효。방법회고성분석2009년9월지2012년2월간남경중의약대학부속의원항장과채용경괄약기간루관결찰술치료적24례복잡성항루환자적림상자료，평개수술료효급환자술후항문괄약기자주공제공능。결과일기수술치유솔위66．7％（16／24）。술후단순괄약기간절구감염2례，경국부응용친수성섬유함은부료환약후유합；4례괄약기간절구감염차내구여항관내상통，경직접절개후유합；완전실효2례，기중1례인술후증상지속이행괘선치료，령1례술후7월복발。림상총치유솔위91．7％（22／24）。술후수방6～44（중위수16）월，극리부란항문실금평분결과현시，환자균무항문괄약기자주공제공능하강。결론경괄약기간루관결찰술시일충치료복잡성항루안전유효적보류괄약기수술。
Objective To evaluate the efficacy of ligation of intersphincteric fistula tract (LIFT) in the treatment of complex fistula-in-ano. Methods Clinical data of 24 patients with complex fistula-in-ano who treated with LIFT in the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2009 to February 2012 were analyzed retrospectively. The operative efficacy and postoperative continence were evaluated. Results The prime success rate of fistula healing was 66.7%(16/24) after the LIFT procedure. Two patients presented with intersphincteric incision infection which was successfully treated with topical of silver nitrate. Four patients had intersphincteric fistula with infection and managed with the complete laying open approach. The total clinical healing rate was 91.7%(22/24). Another 2 patients had persistent external opening with discharge. During follow-up of 6 to 44 (median 16) months, The Cleveland Clinic Florida Fecal Incontinence score revealed that no patient developed decreased continence. Conclusion LIFT is a safe and effective sphincter-preserve procedure for complex fistula-in-ano.