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目的为提高超高位复杂性肛门直肠瘘治疗效果。方法回顾性总结超高位多瘘管复杂性肛门直肠瘘的综合治疗方法：中上段直肠瘘行开腹切除，肛门瘘行肛提肌以下瘘管切除，肛提肌以上主瘘管挂线、支瘘管ＺＴ胶栓塞。结果综合治疗超高位多瘘管复杂性肛门直肠瘘３１１例，其中，单纯开腹３例，开腹＋挂线＋切除６例，开腹＋挂线＋栓塞＋切除４例，挂线＋栓塞４９例，挂线＋栓塞＋切除８７例，单纯瘘管切除１６２例，随访３０３例，治愈２９６例，治愈率９７７％，复发７例，复发率２３％。结论正确处理瘘管内口和瘘管内端，彻底消除支瘘管和死腔窦道内的感染物，保证创口引流和彻底冲洗，是手术成功的关键。综合治疗对高位复杂性肛门直肠瘘具有广泛适用性。
The purpose is to improve ultra-high complexity of anal fistula treatment. Methods To retrospectively summarize the comprehensive treatment of superficial and multiple fistula complex anorectal fistula: upper rectal fistula underwent open excision, anal fistula under the fistula resection, levator ani above the main fistula hanging line, fistula ZT glue embolism. Results A total of 311 cases of ultra-high multiple fistula complex anorectal fistula were treated. Among them, 3 cases were simple open laparotomy, 6 cases were laparotomy + hooking + resection, 4 cases were laparotomy + thread embolization + resection, Cases, hanging wire + embolization + resection in 87 cases, simple fistula resection in 162 cases, 303 cases were followed up, cured 296 cases, the cure rate was 97.7%, 7 cases of recurrence, the recurrence rate was 2.3%. Conclusion The correct treatment of the fistula and the fistula end of the fistula, the complete elimination of the fistula and dead space sinus infection, to ensure wound drainage and thorough flushing is the key to the success of the operation. Comprehensive treatment of high complex anal fistula has a wide range of applicability.