结核性肛瘘的诊治体会

为探讨结核性肛瘘的诊治特点，以提高其一次性治愈率，减少误诊、误治，回顾分析2001年10月至2009年9月我科收治的2]例结核性肛瘘患者的资料。结果显示，21例患者均～次性治愈，创口均一期愈合，愈合时间为17～52d，平均34d。术后无肛门畸形及肛门功能障碍等后遗症。随访1～5年，无复发。结果表明，结核性肛瘘的病理检查具有特征性改变。结核性肛瘘一次性治愈的关键，除早期手术彻底清除病灶外。全程、足量、规律、联合的正规抗结核治疗亦十分重要。术后中药熏洗坐浴和利福平纱条换药，可加速创口愈合。

Experiences on Diagnosis and Treatment of Tuberculous Anal Fistula

In order to probe into the features of diagnosis ＆ treatment for tuberculous anal fistula,so that enhance primary curative rate,and reduce misdiagnosis ＆ mis-cures,the clinical data of 21 patients with tuberculous anal fistula who had undergone treatment from Oct. 2001 to Sep. 2009 in author＇s hospital were analyzed retrospectively. Results showed that all the 21 cases were cured primarily, the surgical wounds were healed primarily and the wound healing time was 17 52 days（averaging 34 days）,and there were no postoperative sequelae such as anal deformity or dysfunction. Follow up of 1-5 years showed no recurrence. It is concluded that the pathology exam of tuberculous anal fistula has characteristic change, thorough clearance of the focus and whole range, full dosage, regularity, associated standardized treatment are the key aspects for the successful treatment of tuberculous anal fistula. Besides,postoperative sitz bath with traditional Chinese drugs and change dressing of rifampicin can promote heal wound.