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肛周脓肿合并感染患者伤口组织中感染微生物的分布特征及伤口愈合的影响因素分析

Analysis of the distribution characteristics of infecting microorganisms in the wound tissue of patients with perianal abscess combined with infection and the influencing factors of wound healing.

作者信息

Qiao Luji, Gao Hongjian, You Yi, Zhu Jinliang

机构信息

The First Ward of Gastrocolorectal Surgery, Shenyang Anorectal Hospital, No. 9 Nanjing North Street, Heping District, Shenyang, 121000, China.

出版信息

BMC Gastroenterol. 2025 Apr 15;25(1):258. doi: 10.1186/s12876-025-03853-8.

Abstract

OBJECTIVE

This study aimed to analyze the distribution characteristics of infecting microorganisms in the wound tissue of patients with perianal abscess and infection, as well as to identify factors affecting wound healing.

METHODS

Two hundred patients with perianal abscess combined with infection admitted to our hospital from January 2023 to May 2024 were selected, all of whom underwent one-time radical surgery, and were divided into 155 cases with good quality of healing and 45 cases with poor quality of healing according to the healing status of wounds in the 2 weeks after surgery, and the traumatized tissue specimenss were collected for the cultivation and identification of infecting microorganisms to analyze the characteristics of the distribution of infecting microorganisms. The clinical data of the patients were collected, and the factors affecting wound healing were investigated using unifactorial and multifactorial analysis.

RESULTS

In this study, 316 strains of infecting microorganisms were detected in two hundred patients, including 213 Gram-negative bacteria, 80 Gram-positive, and 23 fungal strains, of which the Gram-negative bacteria were dominated by Escherichia coli (E. coli)and Klebsiella pneumoniae(K. pneumoniae), and the Gram-positive bacteria were dominated by Staphylococcus aureus. The results of univariate analysis showed that body mass index, diabetes mellitus, concomitant infections, and stool traits were influential factors affecting the poor quality of wound healing (P < 0.05). The results of multifactorial logistic regression analysis showed that body mass index, diabetes mellitus, concurrent infections and stool traits were independent risk factors influencing the poor quality of wound healing (P < 0.05, P<0.05 indicates that the factor is statistically significant).

CONCLUSION

This study suggests that BMI, diabetes, concurrent infection and stool characteristics are independent risk factors for poor wound healing in patients with perianal abscess and infection. In clinical practice, it is recommended to implement personalized interventions targeting the above factors (such as optimizing nutritional support, strict blood glucose control, strengthening infection management, etc.) to improve patient prognosis. In the future, the universality of this conclusion needs to be further verified through multi center and large sample studies.

摘要

目的

本研究旨在分析肛周脓肿合并感染患者伤口组织中感染微生物的分布特征,并确定影响伤口愈合的因素。

方法

选取2023年1月至2024年5月我院收治的200例肛周脓肿合并感染患者,均接受一次性根治手术,根据术后2周伤口愈合情况分为愈合质量良好组155例和愈合质量差组45例,采集创伤组织标本进行感染微生物培养和鉴定,分析感染微生物的分布特征。收集患者临床资料,采用单因素和多因素分析方法探讨影响伤口愈合的因素。

结果

本研究共检测出200例患者感染微生物316株,其中革兰阴性菌213株、革兰阳性菌80株、真菌23株,革兰阴性菌以大肠埃希菌和肺炎克雷伯菌为主,革兰阳性菌以金黄色葡萄球菌为主。单因素分析结果显示,体重指数、糖尿病、合并感染及大便性状是影响伤口愈合质量差的因素(P<0.05)。多因素logistic回归分析结果显示,体重指数、糖尿病、合并感染及大便性状是影响伤口愈合质量差的独立危险因素(P<0.05,P<0.05表示该因素具有统计学意义)。

结论

本研究提示,BMI、糖尿病、合并感染及大便性状是肛周脓肿合并感染患者伤口愈合不良的独立危险因素。临床实践中,建议针对上述因素实施个性化干预措施(如优化营养支持、严格控制血糖、加强感染管理等)以改善患者预后。未来,需通过多中心、大样本研究进一步验证本结论的普遍性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f82b/12001717/47b585983171/12876_2025_3853_Fig1_HTML.jpg

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