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直肠周围感染易呈慢性并形成瘘的原因迄今不明,有关肛腺感染在其发病中的意义,研究所见颇多矛盾。为此,本文对直肠周围瘘的患者进行了病理学研究。60例患者中,男42例,女18例,年龄28～60岁。按作者1979年提出的分类法,本组45例为括约肌内瘘(中央型瘘22例,低位括约肌间瘘20例,高位括约肌间瘘3例),15例为低位括约肌外瘘。对所有患者及20例肛直肠正常者作对照,测定静息时直肠颈部的压力(左侧卧位,距直肠颈外口1、2、3、4和5cm处测定)。按此法同时还测定了32例瘘切除后3～6个月患者的直肠颈压力。手术时在显露中央和括约肌间间隙时确定此两间隙与瘘道的关系。为了进行组织学研究,尽可能完整地解剖和切除瘘管及其分枝。结果:8例中央型瘘的内口位于齿线区,另6例高于齿线平面。46例瘘管成盲管。瘘管病人静息时平均
Reasons for the chronic infection of the perianal rectum and the formation of a fistula have so far been unknown. The significance of the anal gland infection in its pathogenesis is quite contradictory. To this end, the paper on the pathological study of patients with perianal fistula. Of the 60 patients, 42 were male and 18 were female, ranging in age from 28 to 60 years. According to the classification method proposed by the author in 1979, the group of 45 cases were sphincter fistula (22 cases of central fistula, 20 cases of low sphincter fistula, 3 cases of high sphincteric fistula) and 15 cases of low sphincter fistula. All patients and 20 patients with normal anorectal as a control, measured resting neck pressure of the rectum (left lateral position, measured from 1, 2, 3, 4 and 5cm). According to this method, 32 cases of fistula resection were also measured after 3 to 6 months in patients with rectal neck pressure. The relationship between the two spaces and the fistula was determined during the procedure when the space between the center and the sphincter was revealed. For histological studies, dissect and resect the fistula and its branches as completely as possible. Results: The internal foramen of 8 cases with central fistula was located in the dentate line area, and the other 6 cases were higher than the dentate plane. 46 cases of fistula into blind tube. Fistula patients resting average