儿童首次肛周脓肿的各种干预措施的结果
Outcomes of Various Interventions for First-Time Perianal Abscesses in Children.
作者信息
Juth Karlsson Alexander, Salö Martin, Stenström Pernilla
机构信息
Faculty of Medicine, Institution of Clinical Science, Lund University, 221 85 Lund, Sweden.
Institution of Clinical Science, Lund University, Department of Pediatric Surgery, Skåne University Hospital, 221 85 Lund, Sweden.
出版信息
Biomed Res Int. 2016;2016:9712854. doi: 10.1155/2016/9712854. Epub 2016 Jan 5.
INTRODUCTION
In children treated surgically for first-time perianal abscesses, discovery and excision of concomitant fistulas may also be warranted.
AIM
To evaluate children of varying age after incision and drainage of first-time perianal abscesses, examining recurrences rates with and without search for a fistula.
METHOD
A retrospective review was conducted, analyzing children (ages 0-15 years) treated for first-time perianal abscesses at a tertiary pediatric surgical center, with a minimum follow-up of 6 months.
RESULTS
A total of 104 patients subjected to 112 treatments for first-time perianal abscesses were eligible. Surgical procedures constituted 84 (75%) of treatments, searching for fistulas in 49 (58%). In 34 (69%), fistulas were confirmed and treated. In the surgically treated subset, the recurrence rate was higher if no attempt was made to exclude a fistula (46%), as opposed to confirmed absence of a fistula (27%) or concurrent fistulotomy (9%; p = 0.02). Younger patients showed a higher recurrence rate (12/26; 46%), compared with older counterparts (11/58; 19%) (p = 0.002).
CONCLUSION
In children surgically treated for first-time perianal abscess, recurrence rates appear to be lowered by locating and treating coexisting fistulas.
引言
对于首次接受肛周脓肿手术治疗的儿童，也可能有必要发现并切除同时存在的肛瘘。
目的
评估首次肛周脓肿切开引流术后不同年龄段儿童，比较有无探查肛瘘情况下的复发率。
方法
进行一项回顾性研究，分析在一家三级儿科手术中心接受首次肛周脓肿治疗的0至15岁儿童，随访时间至少6个月。
结果
共有104例接受112次首次肛周脓肿治疗的患者符合条件。手术治疗占84次（75%），其中49次（58%）探查了肛瘘。34例（69%）确诊并治疗了肛瘘。在手术治疗亚组中，未尝试排除肛瘘时复发率较高（46%），而确诊无肛瘘时复发率为（27%），同时进行肛瘘切开术时复发率为（9%；p = 0.02）。与年龄较大的儿童（11/58；19%）相比，年龄较小的儿童复发率较高（12/26；46%）（p = 0.002）。
结论
对于首次接受肛周脓肿手术治疗的儿童，发现并治疗并存的肛瘘似乎可降低复发率。
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