ObjectiveTo investigate the expressions of stromal cell-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) in local tissues of perianal abscess and their relationships with clinicopathological features and prognosis of patients.MethodsA total of 47 patients with perianal abscess (perianal abscess group) and 58 patients with mixed hemorrhoids (mixed hemorrhoids group) were selected for the study. The tissues were collected during the operation. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expressions of SDF-1 mRNA and CXCR4 mRNA in local tissues of the two groups, the positive expressions of SDF-1 protein and CXCR4 protein in local tissues were detected by immunohistochemistry, and the relationships between the expressions of SDF-1 and CXCR4 protein and the clinical characteristics, prognosis of patients were analyzed.ResultsThe expression levels of SDF-1 mRNA and CXCR4 mRNA in the perianal abscess group were higher than those in the mixed hemorrhoids group, and the positive rates of SDF-1 protein and CXCR4 protein in the perianal abscess group were higher than those in the mixed hemorrhoids group too (P<0.05). The expressions of SDF-1 protein and CXCR4 protein in perianal abscess tissues were both not related to sex, age, location of abscess, and course of disease (P>0.05), but was related to abscess diameter, healing time, and anal fistula (P<0.05). The non-recurrence rates of SDF-1 protein-negative group and CXCR4 protein-negative group were lower than those of SDF-1 protein-positive group and CXCR4 protein-positive group respectively (P<0.05).ConclusionSDF-1 and CXCR4 molecular are up-regulated in the local tissues of perianal abscess, which are related to the size of abscess, healing time, anal fistula, and recurrence of patients.
OBJECTIVE: To observe the curative effects of basic fibroblast growth factor (bFGF) on anus wound healing. METHODS: From April 1996 to December 2000, out of 109 patients with anus trauma, hemorrhoidectomy or fistula resection, 68 were treated with bFGF as the experimental group, while 41 were treated routinely as the control group. The healing of the wound, the general and local reaction were observed. RESULTS: The healing time of the experimental group was(17.00 +/- 1.54) days while that of the control group was(20.00 +/- 1.16) days (P lt; 0.01). Three weeks after operation, the healing rates of the experimental and control groups were 97.1% and 87.8%, respectively (P lt; 0.01). No general or local detrimental reactions were found in two groups. CONCLUSION: Local application of bFGF can accelerate the healing of anus wound, and the patients have little pain.
ObjectiveTo discuss the effectiveness of deep inferior epigastric artery perforator flap to repair perineal and perianal cicatricial contracture. MethodsBetween March 2007 and December 2013, 23 patients with perineal and perianal cicatricial contracture were treated with deep inferior epigastric artery perforator flap. There were 15 males and 8 females, aged from 21 to 62 years (mean, 42 years). Burn depth was III degree. The burning scars involved in the fascia, even deeper, which was rated as peripheral type (mild stenosis of the anal region and perianal cicatricial contracture) in 13 cases and as central type (severe stenosis of the anal region and anal canal with shift or defect of external genitalia) in 10 cases. All patients had limited hip abduction and squatting. Repair operation was performed at 3 months to 2 years (mean, 6 months) after wound healing. The size of soft tissue defects ranged from 10 cm×6 cm to 28 cm×13 cm after scar excision and release. The size of flaps ranged from 12 cm×7 cm to 30 cm×15 cm. The donor site was sutured directly in 16 cases and repaired by autograft of skin in 7 cases. ResultsThe flap had distal necrosis, distal cyanosis, and spotted necrosis in 1 case, 2 cases, and 1 case respectively, which were cured after symptomatic treatment;the other flaps survived and wound healed primarily. Twenty-one patients were followed up 6 months to 2 years (mean, 1 year). Nineteen patients had good appearance of the perinea and position of external genitalia, normal function of defecation function;stenosis of the anal region was relived, and the flaps had good texture and elasticity. Linear scar contracture was observed at the edge of flap in 2 cases, and the appearance of the perineum was restored after Z plasty. The hip abduction reached 30-40°. No abdominal hernia was found at donor site. ConclusionDeep inferior epigastric artery perforator flap has stable blood supply and flexible design, which is similar to the perianal and perineal tissues. The good effectiveness can be obtained to use this flap for repair of perineal and perianal cicatricial contracture.
目的 探讨一期后位切开挂线左右侧切开引流手术治疗高位马蹄型肛周脓肿的临床效果。方法 前瞻性纳入2008年10月至2010年10月期间庆阳市人民医院收治的60例高位马蹄型肛周脓肿患者，将其随机分成2组，其中观察组30例，行一期后位切开挂线左右侧切开引流术；对照组30例，行一期切开挂线术。比较2组患者的临床疗效。结果 临床疗效观察组为优11例（36.67%），良17例（56.66%），差2例（6.67%），优良率为93.33%（28/30）；对照组为优5例（16.67%），良16例（53.33%），差9例（30.00%），优良率为70.00%（21/30）。观察组的临床疗效优于对照组（P＜0.05）。观察组患者术后肛缘水肿、肛门前移和肛门内陷的发生率以及创面愈合时间均低于或短于对照组（P＜0.05）。2组患者术后均获访1年，均无复发，肛门功能均正常，无畸形。结论 一期后位切开挂线左右侧切开引流术治疗高位马蹄型肛周脓肿的临床疗效确切，患者术后恢复良好，值得临床推广应用。
目的 探讨保留括约肌虚挂线法治疗高位肛周脓肿的临床疗效。 方法 2009年10月－2010年10月采用随机对照试验，对52例高位肛周脓肿患者施行手术治疗，其中保留括约肌虚挂线法（治疗组）26例，切开挂线引流法（对照组）26例。对两组患者术后6个月肛瘘发生率、切口愈合时间、术后1～15 d每晚疼痛视觉模拟评分（VAS）和术后6个月痊愈患者肛门功能后遗症发生率进行比较。 结果 术后6个月，治疗组和对照组肛瘘发生率分别为4.0%和3.8%，差异无统计学意义（P＞0.05）。术后7～15 d治疗组VAS评分均低于对照组，差异有统计学意义（P＜0.05）。两组切口愈合时间分别为（19.05 ± 6.71）d和（21.42 ± 8.40）d，差异有统计学意义（P＜0.05）。术后6个月治疗组痊愈患者肛门功能全部正常，对照组后遗症发生率为12.0%，两组比较差异有统计学意义（P＜0.05）。 结论 保留括约肌虚挂线治疗在术后疼痛、切口愈合时间和保护肛门功能等方面明显优于切开挂线引流治疗，是一种治疗高位肛周脓肿较为理想的方法。