Abel M E, Chiu Y S, Russell T R, Volpe P A
California Pacific Medical Center, San Francisco.
Dis Colon Rectum. 1993 May;36(5):447-9. doi: 10.1007/BF02050009.
This nonrandomized series reports the use of autologous fibrin glue to treat complex rectovaginal and anorectal fistulas. The use of an autologous source to prepare fibrin glue eliminates the risk of disease transmission. Ten patients, six women and four men, with complex fistulas were treated with autologous fibrin glue application. Five patients had rectovaginal fistulas; one of them had Crohn's disease. Five patients had complex anal fistulas; two of them had Crohn's disease, and one had a large postanal ulcer associated with HIV disease. All patients had outpatient preoperative mechanical bowel preparation and prophylactic parenteral antibiotics. Six of the ten patients (60 percent) reported complete healing of the fistulas. Follow-up ranged from three months to one year. Four of five rectovaginal fistulas healed. The two patients with Crohn's disease and complex anal fistulas and the patient with HIV disease did not heal, but all three reported significantly less drainage. Autologous fibrin glue is a viable alternative for the treatment of recurrent rectovaginal and complex abscess/fistulas.
本非随机系列报道了使用自体纤维蛋白胶治疗复杂直肠阴道瘘和肛肠瘘的情况。使用自体来源制备纤维蛋白胶可消除疾病传播风险。10例患有复杂瘘管的患者接受了自体纤维蛋白胶治疗，其中6例为女性，4例为男性。5例患者患有直肠阴道瘘，其中1例患有克罗恩病。5例患者患有复杂肛瘘，其中2例患有克罗恩病，1例患有与艾滋病相关的巨大肛门后溃疡。所有患者术前均接受门诊机械性肠道准备和预防性肠外抗生素治疗。10例患者中有6例（60%）报告瘘管完全愈合。随访时间为3个月至1年。5例直肠阴道瘘中有4例愈合。2例患有克罗恩病和复杂肛瘘的患者以及1例患有艾滋病的患者未愈合，但这3例患者均报告引流明显减少。自体纤维蛋白胶是治疗复发性直肠阴道瘘和复杂脓肿/瘘管的一种可行替代方法。
