国内外肛瘘诊疗现状的对比与启示

发布时间：2018-02-27 15:20

本文关键词： 肛瘘治疗现状调查　出处：《世界华人消化杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的:调查目前国内外肛瘘诊治的具体情况,了解目前国内外肛瘘诊治的现状及发展方向.方法:检索2009-01/2015-12国内外发表的关于肛瘘治疗的相关文献,对肛瘘诊疗过程中的方法和效果进行分析.结果:共获得中文文献612篇,英文文献83篇.对肛瘘的诊断大多数文献仍依靠临床症状和临床物理检查为主,仅少部分文献描述采用腔内超声或MRI进行诊断.在肛瘘的治疗中,中文文献主要采用传统的肛瘘切开切除或切割挂线治疗,英文文献在使用传统治疗方法的同时,保留括约肌的肛瘘手术比例明显增大.术后随访过程中,仍主要依靠临床症状和物理检查对复发肛瘘进行诊断,仅少部分采用腔内超声或MRI进行诊断.结论:国内外对于肛瘘的诊断多以医生经验诊断为主,对于肛瘘的客观诊断均重视不够;国外文献肛瘘以Parks分类方法为主,但是国内文献分类方法不统一;关于治疗方法,国外以括约肌保留手术为主而国内仍以对括约肌损伤较大的传统手术为主;国内外对治疗结果随访更关注复发而忽略了对失禁率的关注.
[Abstract]:Objective: to investigate the current situation of diagnosis and treatment of anal fistula at home and abroad, to understand the present situation and development direction of diagnosis and treatment of anal fistula at home and abroad. Methods: to search the relevant literature on anal fistula treatment published at home and abroad from 2009-01 / 2015-12. Methods and effects of diagnosis and treatment of anal fistula were analyzed. Results: 612 articles in Chinese and 83 articles in English were obtained. In the treatment of anal fistula, the Chinese literature mainly used the traditional anal fistula incision resection or cut thread treatment, while the English literature used the traditional treatment method. The proportion of anal fistula with retaining sphincter was significantly increased. During the follow-up, the diagnosis of recurrent anal fistula was mainly based on clinical symptoms and physical examination. Conclusion: the diagnosis of anal fistula in China and abroad is mainly based on the doctor's experience diagnosis, but not enough on the objective diagnosis of anal fistula, and the foreign literature mainly uses Parks classification method to diagnose anal fistula. However, the classification methods of domestic literature are not uniform. As for treatment methods, sphincter preservation surgery is the main method in foreign countries, while traditional surgery with greater sphincter injury is still used in China. At home and abroad, more attention was paid to the recurrence of the outcome of treatment than to the incontinence rate.
【作者单位】：南京中医药大学第一临床医学院;南京市中医院肛肠科;
【基金】：江苏省中医药局科技基金资助项目;No.LZ11107 南京市医学重点科技发展基金资助项目;No.ZKX13049~~
【分类号】：R657.16

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