摘要
目的分析不同Parks分型肛瘘患者术前肛周MRI的肛瘘及肛门括约肌相关参数特点。方法收集2016年8月至2018年6月在上海中医药大学附属曙光医院肛肠科住院手术治疗且术前完善肛周MRI的括约肌间型肛瘘、经括约肌型肛瘘及括约肌上型肛瘘患者临床资料,测量肛周MRI图像上肛瘘高度、内口高度,肛门内、外括约肌厚度及肛门内外括约肌间隙距离,记录各数据。结果共纳入括约肌间型肛瘘300例(71.3%),经括约肌型肛瘘105例(24.9%),括约肌上型肛瘘16例(3.8%)。括约肌间型肛瘘、经括约肌型肛瘘、括约肌上型肛瘘的肛瘘高度及内口高度有依次逐渐增大的趋势,肛门内、外括约肌厚度有依次逐渐增厚的趋势。括约肌间型肛瘘、括约肌上型肛瘘的肛门内外括约肌间隙距离在前侧、两侧、后侧有依次逐渐增大的趋势,经括约肌型肛瘘未观察到类似的现象。结论不同Parks分型的肛瘘患者其肛瘘高度、内口高度及肛门内、外括约肌厚度存在一定程度的差异,同一类型肛瘘各点位肛门内外括约肌间隙距离也有着不同的表现,而肛门内、外括约肌厚度及肛门内外括约肌间隙距离的不同也可能对肛瘘形成的过程有影响。
Objectives To analyze the characteristics of anal fistula and sphincter-related parameters from preoperative perianal magnetic resonance imaging(MRI)among different types of anal fistulas(Parks).Methods Patients with different types of anal fistula(intersphincteric fistula,transsphincter fistula,and suprasphincter fistula)who received surgical treatment at the Department of Anorectal Diseases,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,between August 2016 and June 2018 and underwent preoperative perianal MRI were selected.Based on the MRI,the following were measured:anal fis⁃tula height,internal fistula orifice height,internal and external sphincter thickness,and the space between the internal and ex⁃ternal sphincter.Results Three hundred(71.3%)patients with intersphincteric fistula,105(24.9%)patients with transsphincter fis⁃tula,and 16(3.8%)patients with suprasphincter fistula were included.From intersphincteric fistula,transsphincter fistula,to supra⁃sphincter fistula,there were trends toward increasing anal fistula height,increasing internal fistula orifice height,and increasing internal and external sphincter thickness.In intersphincteric fistula and suprasphincter fistulas,there were trends toward increas⁃ing space between the internal and external sphincter from anterior,bilateral,to the posterior side.Such trends were not ob⁃served in transsphincter fistula.Conclusion The anal fistula height,the internal fistula orifice height,and the internal and external sphincter thickness varied among different types of anal fistula(Parks).For a specific type of anal fistula,the space between the internal and external sphincter varied at different sides.These varying thickness of internal and external sphincter and the space between the internal and external sphincter may affect the development of anal fistula.
作者
邹琪琦
陈步强
杨达成
徐进
朱静怡
汪庆明
Zou Qiqi;Chen Buqiang;Yang Dacheng;Xu Jin;Zhu Jingyi;Wang Qingming(Department of Anorectal Diseases,Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Department of Anorectal Diseases,Shanghai Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 200200,Chi-na;Department of Anorectal Diseases,Baoshan Branch,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201901,China;Department of Anorectal Diseases,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shang-hai 201203,China)
出处
《结直肠肛门外科》
2021年第5期474-477,共4页
Journal of Colorectal & Anal Surgery
基金
海派中医流派浦东基地(顾氏外科)(PDZY-2018-0702)。
关键词
肛瘘
肛周MRI
肛门括约肌
肛门内外括约肌间隙
anal fistula
perianal MRI
sphincter
space between the internal and external sphincter
