脱细胞真皮基质补片治疗小儿肛瘘

背景：采用异体脱细胞真皮基质材料填塞治疗成人低位肛瘘具有较好的临床效果。目的：探讨脱细胞异体真皮基质补片修补小儿肛瘘的可行性以及方法。方法：将138例肛瘘患儿随机分为2组,用可吸收线将脱细胞异体真皮基质生物补片固定在直肠黏膜下,A组双层缝合封闭内口,B组不游离、缝合内口。结果与结论：随访观察6个月,所有病例肛周无红肿,外观无异常,外口硬结消失,内口愈合良好,无肛门狭窄及肛门外形改变。两组在修复后均有部分患儿出现瘘口出流便,但未经特殊处理,症状均自行消失,痊愈。A组术后瘘口漏便患儿人数较B组多（P〈0.01）,出现时间较B组早（P〈0.05）,但总体愈合时间无差异。说明手术中仅固定补片于内口,而不游离、缝合内口即可达到满意疗效。

Acellular dermal matrix patch for treatment of pediatric anal fistula

BACKGROUND： Allogenous acellular dermal matrix patches have a good clinical effect on adult anal fistula. OBJECTIVE： To investigate the feasibility and approach of allogenous acellular dermal matrix patches in repair of pediatric anal fistula. METHODS： Totally 138 cases of pediatric anal fistula were randomized into two groups to receive allogenous acellular dermal matrix patch suture： group A, double-layer suture closure; group B, non-free suture. RESULTS AND CONCLUSION： All the cases were followed for 6 months. There were no perianal swelling, abnormal appearance, induration, anal stenosis and anal shape change. After repair, some children presented with reuben from the fistula that was healed without treatment. The number of children with reuben from the fistula in group A was higher than that of group B （P 0.01）, and the appearance time was also earlier in group A （P 0.05）. Allogenous acellular dermal matrix patch has a good effect on pediatric anal fistula.