肛周脓肿单纯切开引流术后发生肛瘘的危险因素分析  

Risk factors for developing anal fistula after simple incision and drainage for peri⁃anal abscess

作　　者：许曼 许愿 吴人杰[1] 黄晓琳 陶冉 吴炯[1] Xu Man;Xu Yuan;Wu Renjie;Huang Xiaolin;Tao Ran;Wu Jiong(Department of Anorectal Diseases,Yueyang Hospital of Intergrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院肛肠科,上海200437

出　　处：《结直肠肛门外科》2020年第6期683-686,共4页Journal of Colorectal & Anal Surgery

基　　金：上海市科学技术委员会科研计划项目(18401904100);上海中医药大学附属岳阳中西医结合医院院级基金项目(2018YJ14)。

摘　　要：目的分析肛周脓肿单纯切开引流术后发生肛瘘的危险因素。方法分析本院2014年3月至2018年12月收治的879例首诊为肛周脓肿并行切开引流术患者的临床资料,采用Logistic回归分析探讨肛周脓肿术后发生肛瘘的危险因素。结果996例患者均顺利完成切开引流术,术后随访3~62个月,中位随访时间为31(13,45)个月,脱落117例,脱落率为11.7%,最终共879例患者纳入分析。879例患者中,641例(72.9%)患者术后发生肛瘘,余238例(27.1%)患者术后未发生肛瘘。单因素分析结果显示发生肛瘘组的60岁以下及男性患者比例高于未发生肛瘘组(均P<0.05),两组有糖尿病史、不同脓肿点位、发热、有吸烟史、术前使用抗生素、既往有肛周脓肿病史患者比例比较差异均无统计学意义(均P>0.05)。Logistic回归分析结果显示男性和年龄<60岁是肛周脓肿术后发生肛瘘的独立影响因素(均P<0.05)。结论男性和年龄<60岁是肛周脓肿术后发生肛瘘的独立危险因素,可根据患者是否合并危险因素合理选择肛周脓肿的手术方式,以为患者带来最大获益。Objectives To investigate the risk factors for developing anal fistula after simple incision and drainage for perianal abscess.Methods This was a retrospective analysis of 879 patients with perianal abscess undergoing simple incision and drain⁃age at our hospital between March 2014 and December 2018.Logistic regression analysis was performed to determine risk fac⁃tors for developing anal fistula after simple incision and drainage for perianal abscess.Results There were 996 patients who un⁃derwent simple incision and drainage.Patients were followed up for 3 to 62 months with a median duration of 31(13,45)months.117(11.7%)patients were lost-to-follow-up.A total of 879 patients were included in the final analysis,among whom 641(72.9%)developed anal fistula.The remaining 238(27.1%)patients did not develop anal fistula.Univariate analysis showed that the proportions of patients under 60 and men who developed anal fistula were significantly higher than those who did not devel⁃op anal fistula(P<0.05).Diabetes mellitus,abscess location,fever,smoking history,postoperative antibiotics use,and perianal ab⁃scess history did not differ between the two groups(P>0.05).Multivariate Logistic regression analysis showed that men and under 60 were independent risk factors for developing anal fistula after surgery for perianal abscess(P<0.05).Conclusion Men and un⁃der 60 independent risk factors for developing anal fistula after surgery for perianal abscess.To achieve good clinical outcomes,surgeons should select optimal surgery for perianal abscess by a thorough consideration of all risk factors.

关 键 词：肛周脓肿 单纯切开引流术 肛瘘 危险因素 

分 类 号：R657.16[医药卫生—外科学]