Sun Yanting,Liang Hongtao,Wang Chen.Advances in etiologies and treatments of infantile fistula-in-ano[J].Journal of Clinical Pediatric Surgery,2021,20(01):69-73.[doi:10.12260/lcxewkzz.2021.01.014]
婴幼儿肛瘘发病相关因素与治疗的研究进展
- Title:
- Advances in etiologies and treatments of infantile fistula-in-ano
- Keywords:
- Rectal Fistula/ET; Rectal Fistula/SU; Rectal Fistula/TH; Infant
- 分类号:
- R657.1;R726.5
- 摘要:
- 肛瘘是指直肠或肛管与肛门周围皮肤相通所形成的异常通道。婴幼儿肛瘘是指发生在0~3岁婴幼儿的肛管直肠瘘，起初以肛周脓肿的急性炎症为表现，后逐步进入形成肛瘘的慢性炎症期。由于婴幼儿处于特殊的生长阶段，导致婴幼儿肛瘘与成人肛瘘存在许多差异。本文从流行病学、临床表现、发病原因和治疗方法四方面总结归纳婴幼儿肛瘘的研究现状及治疗进展。
- Abstract:
- Anal fistula refers to abnormal passage formed by a connection between rectum or anal canal and skin around anus.Infantile fistula-in-ano refers to an anorectal fistula occurring in infants aged 0 to 3 years.Initially it is manifested by acute inflammation of perianal abscess and then there is a chronic inflammatory period of formation.Infantile fistula-in-ano differs in many respects from its adult counterpart.This article summarizes current status and research advances of epidemiology,clinical manifestations,etiologies and therapeutics.Aiming at exploring a therapeutic breakthrough,the authors summarized existing problems on the basis of literature and offered insights of enhancing clinical efficacies.
参考文献/References:
1 Venturo RC.Fistula-in-ano in infants[J].Am J Surg,1953,86(5):641-642.DOI:10.1016/0002-9610(53)90371-7.
2 Matt JG.Anal fistula in infants and children[J].Dis Colon Rectum,1960,3(3):258-261.DOI:10.1007/BF02616564.
3 Hill JR.Fistulas and fistulous abscesses in the anorectal region:personal experience in management[J].Dis Colon Rectum,1967,10(6):421-434.DOI:10.1007/bf02616813.
4 Mazier WP.The Treatment and care of anal fistulas:a study of 1000 patients[J].Dis Colon Rectum,1971,14(2):134-144.DOI:10.1007/bf02560060.
5 Emile SH,Elfeki H,Abdelnaby M.A systematic review of the management of anal fistula in infants [J].Tech Coloproctol,2016,20(11):1-10.DOI:10.1007/s10151-016-1536-1.
6 Oh JT,Han A,Han SJ,et al.Fistula-in-ano in infants:Is nonoperative management effective? [J].J Pediatr Surg,2001,36(9):1367-1369.DOI:10.1053/jpsu.2001.26372.
7 Brem H,Guttman FM,Laberge JM,et al.Congenital anal fistula with normal anus[J].J Pediatr Surg,1989,24(2):183-185.DOI:10.1016/s0022-3468(89)80245-3.
8 Gangopadhyay AN,Pandey V.Anorectal malformations[J].J Indian Assoc Pediatr Surg,2015,20(1):10-15.DOI:10.4103/0971-9261.145438.
9 Fitzgerald RJ,Harding B,Ryan W.Fistula-in-ano in childhood:a congenital etiology[J].J Pediatr Surg,1985,20(1):80-81.DOI:10.1016/s0022-3468(85)80399-7.
10 Shafer AD,Mcglone TP,Flanagan RA.Abnormal crypts of Morgagni:The cause of perianal abscess and fistula-in-ano[J].J Pediatr Surg,1987,22(3):203-204.DOI:10.1016/s0022-3468(87)80327-5.
11 al-Salem AH,Qaisaruddin S,Qureshi SS.Perianal abscess and fistula in ano in infancy and childhood:a clinicopathological study[J].Pediatr Pathol Lab Med,1996,16(5):755-764.DOI:10.1080/15513819609169302.
12 Assa A,Amitai M,Greer ML,et al.Perianal pediatric Crohn’s disease is associated with a distinct phenotype and greater inflammatory burden[J].J Pediatr Gastroenterol Nutr,2017,65(3):293-298.DOI:10.1097/MPG.0000000000001484.
13 Torow N,Marsland BJ,Hornef MW,et al.Neonatal mucosal immunology[J].Mucosal Immunol,2017,10(1):5-17.DOI:10.1038/mi.2016.81.
14 Ferrazzini G,Kaiser RR,Hirsig Cheng SK,et al.Microbiological aspects of diaper dermatitis[J].Dermatology,2003,206(2):136-141.DOI:10.1159/000068472.
15 Serour F,Somekh E,Gorenstein A.Perianal abscess and fistula-in-ano in infants:a different entity?[J].Dis Colon Rectum,2005,48(2):359-364.DOI:10.1007/s10350-004-0844-0.
16 Juth Karlsson A,Sal? M,Stenstr?m P.Outcomes of various interventions for first-time perianal abscesses in children[J].Biomed Res Int,2016,2016:1-6.DOI:10.1155/2016/9712854.
17 Ezer SS,O?uzkurt P,Ince E,et al.Perianal abscess and fistula-in-ano in children:Aetiology,management and outcome[J].J Paediatr Child Health,2010,46(3):92-95.DOI:10.1111/j.1440-1754.2009.01644.x.
18 Gong Z,Han M,Wu Y,et al.Treatment of first-time perianal abscess in childhood,balance recurrence and fistula formation rate with medical intervention[J].Eur J Pediatr Surg,2018,28(4):373-377.DOI:10.1055/s-0037-1603092.
19 Christison-Lagay ER,Hall JF,Wales PW,et al.Nonoperative management of perianal abscess in infants is associated with decreased risk for fistula formation[J].Pediatrics,2007,120(3):e548-e552.DOI:10.1542/peds.2006-3092.
20 Turck D,Bernet JP,Marx J,et al.Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population[J].J Pediatr Gastroenterol Nutr,2003,37(1):22-26.DOI:10.1097/00005176-200307000-00004.
21 Chang HK,Ryu JG,Oh JT.Clinical characteristics and treatment of perianal abscess and fistula-in-ano in infants[J].J Pediatr Surg,2010,45(9):1832-1836.DOI:10.1016/j.jpedsurg.2010.03.021.
22 Rosen NG,Gibbs DL,Soffer SZ,et al.The nonoperative management of fistula-in-ano[J].J Pediatr Surg,2000,35(6):938-939.DOI:10.1053/jpsu.2000.6931.
23 Ohya T,Usui Y,Okamoto K,et al.Management for fistula-in-ano with Ginseng and Tang-kuei Ten Combination[J].Pediatr Int,2004,46(1):72-76.DOI:10.1111/j.1442-200x.2004.x.
24 Kubota M,Hirayama Y,Okuyama N.Usefulness of bFGF spray in the treatment of perianal abscess and fistula-in-ano[J].Pediatr Surg Int,2010,26(10):1037-1040.DOI:10.1007/s00383-010-2664-8.
25 Gafar AMAA.Fistulotomy versus fistulectomy as a treatment for low anal fistula in infants:A comparative study[J].Annals of Pediatric Surgery,2013,9(3):103-107.DOI:10.1097/01.XPS.0000430519.91184.f6.
26 Festen C,Harten H.Perianal abscess and fistula-in-ano in infants[J].J Pediatr Surg,1998,33(5):711-713.DOI:10.1016/s0022-3468(98)90193-2.
27 Poenaru D,Yazbeck S.Anal fistula in infants:Etiology,features,management[J].J Pediatr Surg,1993,28(9):1194-1195.DOI:10.1016/0022-3468(93)90163-f.
28 张少军,杨巍.古代肛瘘挂线术的发展及思考[J].江苏中医药,2012,44(4):69-70.DOI:10.3969/j.issn.1672-397X.2012.04.040.Zhang SJ,Yang W.Developments and thoughts on thread-drawing in the treatment of anal fistula in ancient times[J].Jiangsu J Tradit Chin Med,2012,44(4):69-70.DOI:10.3969/j.issn.1672-397X.2012.04.040.
29 陈白波.中医挂线疗法在肛肠病的应用[J].中外医疗,2011,30(13):130.DOI:10.16662/j.cnki.1674-0742.2011.13.107.Chen BB.Application of thread-drawing in traditional Chinese medicine for anorectal diseases[J].Chin Forgn Med Treat,2011,30(13):130.DOI:10.16662/j.cnki.1674-0742.2011.13.107.
30 Inoue M,Sugito K,Ikeda T,et al.Long-term results of seton placement for fistula-in-ano in infants[J].J Gastrointest Surg,2014,18(3):580-583.DOI:10.1007/s11605-013-2351-x.
31 Ikeda T,Inoue M,Sugitou K,et al.Treatment of fistula-in-ano in infants with a seton[J].J Pediatr Surg,2007,42(6):1095-1097.DOI:10.1016/j.jpedsurg.2007.01.062.
32 高彦江.改良挂线引流手术治疗儿童复杂性肛瘘的临床观察[J].实用临床医学,2014,15(8):73.Gao JY.Clinical observations of improved thread-drawing therapy for complex anal fistula in children[J].Pract Clin Med,2014,15(8):73.
33 徐青,曹永清.拖线法治疗中医外科疾病的研究进展 [J].中华中医药杂志,2016,31(1):205-207.Xu Q,Cao YQ.Recent advances of thread-dragging therapy for surgical diseases of traditional Chinese medicine[J].Chin J Tradit Chin Med Pharm,2016,31(1):205-207.
34 王明华,唐一多,郭修田,等.拖线法治疗婴幼儿低位单纯性肛瘘21例 [J].中西医结合学报,2005,3(3):231-232.Wang MH,Tang YD,Guo XT,et al.Treatment of simple low anal fistula with thread-drawing therapy in infants and toddlers:a report of 21 cases[J].J Chin Integr Med,2005,3(3):231-232.
35 蒋晓雪,王琛,曹永清,等.陆金根中西医结合治疗小儿肛瘘经验[J].上海中医药大学学报,2017,31(6):1-4.DOI:10.16306 /j.1008-861x.2017.06.001.Jiang XX,Wang C,Cao YQ,et al.Combined Chinese and western medicine treatment of fistula-in-ano in infants by Professor Lu Jingen[J].Acta Univ Tradit Med Sin Pharmacol Shanghai,2017,31(6):1-4.DOI:10.16306 /j.1008-861x.2017.06.001.
36 Limura E,Giordano P.Modern management of anal fistula[J].World J Gastroenterol,2015,21(1):12-20.DOI:10.3748/wjg.v21.i1.12.
37 Kouchi K,Takenouchi A,Matsuoka A,et al.Efficacy of an anal fistula plug for fistulas-in-ano in children[J].J Pediatr Surg,2017,52(8):1280-1282.DOI:10.1016/j.jpedsurg.2017.01.062.
38 Osman MA,Elsharkawy MA,Othman MH.Repair of fistulae in-ano in children using image guided Histoacryl injection after failure of conservative treatment[J].J Pediatr Surg,2013,48(3):614-618.DOI:10.1016/j.jpedsurg.2012.11.029.
39 Pini Prato A,Zanaboni C,Mosconi M,et al.Preliminary results of video-assisted anal fistula treatment (VAAFT) in children[J].Tech Coloproctol,2016,20(5):279-285.DOI:10.1007/s10151-016-1447-1.
相似文献/References:
[1]刘风英,李贵信.Ⅰ期手术切除小儿肛瘘32例[J].临床小儿外科杂志,2007,6(03):23.
[2]陈快 黄金狮 陶俊峰 樊伟 刘智文 徐美汉 刘玉 陶强.腹腔镜手术治疗先天性无肛并直肠尿道瘘１５例[J].临床小儿外科杂志,2013,12(01):47.
备注/Memo
收稿日期:2020-02-24。
基金项目:国家自然科学基金（编号：81603624）；上海市进一步加快中医药事业发展三年行动计划（编号：ZY（2018-2020）-CCCX-1007）；上海中医药大学优秀本科生跟踪本硕博一体化培养计划（沛然计划）（教学420）
通讯作者:梁宏涛,Email:hongtao.liang@shutcm.edu.cn