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研究影响肛周脓肿手术后预后的因素。

Study on the factors influencing the prognosis after perianal abscess surgery.

机构信息

Department of anus-intestines, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, No. 68 Gehu Middle Road, Wujin District, 213000, 213000, Changzhou, China.

Department of Medical Imaging, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213000, China.

出版信息

BMC Gastroenterol. 2023 Sep 27;23(1):334. doi: 10.1186/s12876-023-02959-1.

Abstract

OBJECTIVE

To study the influence of clinical characteristics and diagnosis and treatment methods of perianal abscess on postoperative recurrence or formation of anal fistula to provide a basis for selecting appropriate surgical and inspection methods for clinical treatment of perianal abscess in the future.

METHODS

The clinical data of 394 patients with perianal abscesses were collected, the influencing factors were investigated, and univariate analysis and multivariate logistic regression analysis were performed to further determine the risk factors affecting the prognosis of perianal abscess.

RESULTS

The results showed that the rate of preoperative blood routine results in the uncured group was higher (51.16%) than in the cured group (35.61%); the rate of high abscess space in the uncured group (23.26%) was higher than in the cured group (9.11%); the proportion of patients in the uncured group who underwent magnetic resonance imaging (MRI) before surgery (27.90%) was lower than in the cured group (45.30%); the proportion of patients in the uncured group who underwent simple drainage (51.16%) was higher than in the cured group (28.49%). The two groups had significant differences in perineal MRI examination, surgical method, preoperative blood routine, and abscess space (p = 0.030, p = 0.002, p = 0.047 and p = 0.010, respectively). Based on the results of univariate analysis and multivariate logistic regression analysis, the extent of the abscess cavity (OR = 2.544, 95%CI = 1.087-5.954, p = 0.031) and the surgical method (OR = 2.180, 95%CI = 1.091-4.357, p = 0.027) were independent influencing factors for postoperative recurrence of perianal abscess or anal fistula.

CONCLUSION

Preoperative assessment of the abscess range and precise intraoperative methods to resolve the infection of the abscess glands in the internal mouth can effectively improve the cure rate.

摘要

目的

研究肛周脓肿的临床特征、诊断和治疗方法对术后复发或形成肛瘘的影响,为今后临床治疗肛周脓肿选择合适的手术和检查方法提供依据。

方法

收集 394 例肛周脓肿患者的临床资料,分析影响因素,对单因素和多因素 logistic 回归分析进行分析,进一步确定影响肛周脓肿预后的危险因素。

结果

结果显示,未治愈组术前血常规结果异常率(51.16%)高于治愈组(35.61%);未治愈组高位脓肿比例(23.26%)高于治愈组(9.11%);未治愈组术前接受磁共振成像(MRI)检查的患者比例(27.90%)低于治愈组(45.30%);未治愈组单纯引流的患者比例(51.16%)高于治愈组(28.49%)。两组在会阴部 MRI 检查、手术方式、术前血常规、脓肿位置方面差异均有统计学意义(p=0.030、p=0.002、p=0.047、p=0.010)。基于单因素分析和多因素 logistic 回归分析结果,脓肿腔范围(OR=2.544,95%CI=1.087-5.954,p=0.031)和手术方式(OR=2.180,95%CI=1.091-4.357,p=0.027)是影响肛周脓肿术后复发或形成肛瘘的独立影响因素。

结论

术前评估脓肿范围,术中采用精确的方法解决内口脓肿腺体感染,可以有效提高治愈率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da44/10537581/7b1dc2afbe89/12876_2023_2959_Fig1_HTML.jpg

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