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目的采用CT小肠造影(CTE)探讨克罗恩病回结肠病变与是否伴发肛瘘之间的关系。方法连续收集在本院确诊为克罗恩病回结肠病变活动期且接受CTE及肛管MRI的患者28例,其中肛瘘组16例、无肛瘘组12例,计算患者回盲部及结直肠病变的数目、最大病变的长度及相邻病变间的最小距离,并通过秩和检验分析2组间是否具有差异。结果28例患者中,肛瘘组87.50%(14/16)累及左半结肠或直肠,无肛瘘组50.00%(6/12)累及左半结肠或直肠,差异有统计学意义(Z=-2.135,P<0.05);肛瘘组回结肠克罗恩病的平均病变数目为3.06个,非肛瘘组为2.91个,差异无统计学意义(P>0.05);肛瘘组最大病变长度为(12.79±8.30)cm,无肛瘘组为(7.04±3.09)cm,差异无统计学意义(P>0.05);肛瘘组相邻病变间的最小距离为(5.23±2.98)cm,无肛瘘组为(8.44±2.87)cm,差异有统计学意义(Z=-2.095,P<0.05)。结论克罗恩病是否发生肛瘘与病变位置及相邻病变间的距离有关,而与病变的数目和最大病变长度无关。
Objective To investigate the relationship between the pathological changes of Crohn’s disease and the anal fistula by CT small bowel angiography (CTE). Methods Totally 28 patients were enrolled in this study. Among them, 16 were anal fistulas and 12 were without anal fistulas. The patients were diagnosed as ileocecal and colorectal lesions The length of the largest lesions and the minimum distance between adjacent lesions, and by rank sum test to analyze whether there are differences between the two groups. Results Of the 28 patients, 87.50% (14/16) of the anal fistula group involved the left colon or rectum, and 50.00% (6/12) of the fistula-free group involved the left colon or rectum with a statistically significant difference (Z = -2.135, (P> 0.05). The average number of Crohn’s disease in the anal fistula group was 3.06 and that in the non-anal fistula group was 2.91, with no significant difference (P> 0.05). The maximum length of the lesion in the anal fistula group was (12.79 ± 8.30) cm, and no anal fistula was (7.04 ± 3.09) cm, the difference was not statistically significant (P> 0.05). The minimum distance between adjacent lesions was (5.23 ± 2.98) cm in anal fistula group and (8.44 ± 2.87) cm, the difference was statistically significant (Z = -2.095, P <0.05). Conclusion The incidence of anal fistula in Crohn’s disease is related to the location of the lesion and the distance between adjacent lesions, but not to the number of lesions and the length of the maximal lesion.