肛瘺診治進展ppt課件-資料下載頁
2025-05-03 03:31本頁面
【正文】 ted by fistulotomy. Healing rates after fistulotomy or intersphincteric and low transsphincteric Crohn’s fistulas range from 62 to 100% with reported minor incontinence rates of 0 to 12%. These wounds may take up to three to six months to heal. 3. Guideline: Complex Crohn’s fistulas may be well palliated with longterm draining setons. The goal of a longterm loose (draining) seton for Crohn’s fistulas is to reduce the number of subsequent septic events by providing continuous drainage and preventing closure of the external skin opening. This goal can be achieved in 48 to 100% of such patients. Recurrent sepsis is seen approximately onethird of the time. 4. Guideline: Complex Crohn’s fistulas may be treated with advancement flap closure if the rectal mucosa is grossly normal. Endorectal or anodermal advancement flaps also can be used in patients with plex fistulas from Crohn’s disease. Active proctitis is considered a contraindication. Shortterm success (generally 50– 75%) is lower in patients with Crohn’s disease and continues to diminish with longer followup, demonstrating the chronic relapsing nature of this disease. Shortterm success rates for rectovaginal fistulas associated with Crohn’s disease are even lower at 40 to 50%. 肛瘺手術(shù)治療成功的關(guān)鍵或失敗的原因分析： 術(shù)前 關(guān)注： ?? 病因、診斷是否清楚； 病史？ 非腺源性肛瘺 ？術(shù)前檢查？ ?? 治療方式選擇是否適當(dāng)； 術(shù)中 關(guān)注： ?? 處理方法是否適當(dāng)：內(nèi)口、主管支管處理、通暢引流等； 術(shù)后 關(guān)注： ?? 術(shù)后隨訪、創(chuàng)面檢查、緊線等是否及時； 謝 謝
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