摘要
目的:当前临床中存在部分肛瘘患者术后伤口难以愈合,其结核筛查结果阳性或结果为阴性,但其症状体征高度怀疑结核的患者,通过予以抗结核治疗后伤口得到痊愈,此提示抗结核治疗在该类患者中的必要性,为临床中肛瘘术后伤口不愈的患者提供临床诊疗思路。方法:对厦门市中医院肛肠科近5年诊治的15例结核性肛瘘患者的临床资料进行回顾性分析,通过观察患者抗结核治疗前后的结核筛查结果、创面愈合情况、与结核相关全身不适症状情况及肝肾功能指标,并对其进行分析比较。结果:15例患者,平均住院7.53d,经过住院治疗及出院后的康复治疗,14例随访6个月至2年,1例患者正处于术后恢复期,创面愈合良好,结核菌素皮肤试验等结核筛查均为阴性。结论:对于确诊或高度怀疑结核性肛瘘的患者,准确清除肛瘘病灶和及时运用抗结核药是治疗的关键。
Objective:At present,there are some patients with anal fistula who have difficult wound healing after surgery.Their tuberculosis screening results are positive or negative,but their symptoms and signs are highly suspected of tuberculosis,and the wounds are healed after anti-tuberculosis treatment.This suggests the necessity of anti-tuberculosis treatment in such patients,in order to provide clinical diagnosis and treatment ideas for patients with unhealed wounds after anal fistula surgery.Method:The clinical data of 15 patients with tuberculous anal fistula treated in the Anorectal Department of Xiamen Hospital of Traditional Chinese Medicine in the past 5 years were retrospectively analyzed.The tuberculosis screening results,wound healing,tuberculosis-related systemic discomfort symptoms,liver and kidney function indexes before and after anti-tuberculosis treatment were observed and compared.Results:The 15 patients were hospitalized for 7.53 days on average.After hospitalization and rehabilitation treatment after discharge,14 patients were followed up for 6 months to 2 years,and 1 patient was in the postoperative convalescence stage with good wound healing.They had negative tuberculosis screenings,including the tuberculin skin test.Conclusion:For patients with confirmed or highly suspected tuberculous anal fistula,accurate removal of anal fistula lesions and timely use of anti-tuberculosis drugs are the key to treatment.
作者
张华彬
江俊林
张志谦
ZHANG Huabin;JIANG Junlin;ZHANG Zhiqian(Fujian University of Traditional Chinese Medicine,Fujian Fuzhou 350122,China;Xiamen Hospital of Traditional Chinese Medicine,Fujian Xiamen 361009,China)
出处
《中医药临床杂志》
2024年第3期556-559,共4页
Clinical Journal of Traditional Chinese Medicine
基金
国家中医药管理局重点专科:(ZK1301GC037)
福建省中医重点专科
福建中医药大学校管课题(编号:XB2021102)
厦门市中医院肛肠科是厦门市医学重点学科
厦门市盆底动力学重点实验室。
关键词
结核
肛瘘
临床分析
Tuberculosis
Anal fistula
Clinical analysis
