- 期刊
Applying Endoanal Ultrasound for Anal Fistula: A Single Instrument Approach
經肛門超音波在肛門廔管之應用－單一機構之經驗
摘要
目的 在肛門廔管的術前評估，經肛門超音波的臨床運用。方法 從2015年5月到2016年1月，收集45個臨床懷疑是肛門廔管的病人，全部病人都有接受經肛門超音波檢查，使用的超音波機器型號為BK Diagnostic ultrasoundsystem，合併使用6-12赫茲的360度影像超音波探頭。有11個病人同時接受肛門廔管X光檢查。其中有16個病人有接受經H_2O_2的注射。結果 經肛門超音波的平均操作時間為四分鐘(標準差為兩分鐘十秒)，時間範圍從一分二十秒到九分二十秒，總共有34個病人接受開刀。經直腸超音波的診斷準確率為88.23%，而敏感度和特異度為86.2% (25/29)和100% (5/5)。而肛門廔管X光檢查的準確率為75%，其敏感度和特異度為66.7% (4/6)和100% (2/2)。結論 因為較高的診斷準確率和較低成本花費，經直腸超音波可以提供更有用的臨床實際應用。經直腸超音是對於肛門廔管有效的第一線術前評估。
並列摘要
Purpose. In this study, we compared the clinical practice of endoanal ultrasound. Methods. The data of 45 patients with a clinical diagnosis of anal fistula from May 2015 to January 2016 were collected in this retrospective study. All the patients had received endoanal ultrasound. We used a BK Diagnostic Ultrasound System with a 6-12 MHz endo-probe that provided a 360° image. Eleven patients underwent both endoanal ultrasound and fistulography. A total of 16 patients received injected hydrogen peroxide during examination. Results. The mean performance time of endoanal ultrasound was approximately 4 minutes (SD: 2 minutes and 10 seconds), with times ranging from 1 minute and 20 seconds to 9 minutes and 20 seconds. Thirty-four patients received fistulotomy or fistulectomy. The accuracy of endoanal ultrasound was 88.23% and its sensitivity and specificity were 86.2% (25/29) and 100% (5/5), respectively. The accuracy of fistulography was 75%, and its sensitivity and specificity of fistulography in our study were 66.7% (4/6) and 100% (2/2), respectively. Conclusions. Because of its high accuracy and low cost, endoanal ultrasound is feasible forclinical practice. We consider endoanal ultrasound to be aneffective, and first-line pre-operative assessment for anal fistula.