肛周脓肿切开引流术后瘘管形成的影响因素分析  

Influencing factors of fistula formation after incision and drainage of perianal abscesses

作　　者：彭俞俞 Peng Yuyu(Department of proctology,Panshan County People's Hospital,Panjin 124101,China)

机构地区：[1]辽宁省盘山县人民医院肛肠科,124101

出　　处：《国际医药卫生导报》2021年第23期3611-3613,共3页International Medicine and Health Guidance News

基　　金：国家“十二五”科技支撑计划项目(2014BAI10B00)。

摘　　要：目的探讨肛周脓肿切开引流术后瘘管形成的影响因素。方法采用观察性研究回顾性分析2017年12月至2019年12月盘山县人民医院收治的60例肛周脓肿行切开引流术患者的临床资料(性别、年龄、脓肿类型、脓肿位置以及术后是否规范应用抗菌药物),所有患者行切开引流术治疗,术后随访半年,统计术后是否形成瘘管,根据是否形成瘘管分为形成瘘管组和未形成瘘管组,分析肛周脓肿切开引流术后瘘管形成的影响因素。结果纳入的60例患者中男30例、女30例,年龄(46.68±3.75)岁,肛周皮下脓肿30例、坐骨直肠窝脓肿16例、括约肌间脓肿3例、肛提肌上脓肿6例、直肠黏膜下脓肿5例;术后随访半年,60例患者中有11例形成瘘管(18.33%);单因素分析结果显示肛周脓肿行切开引流术后瘘管形成可能受性别(P=0.003)和术后是否规范应用抗菌药物(P<0.001)有关;logistic回归分析结果显示性别为男性(OR=14.500,P=0.001)、术后未规范应用抗菌药物(OR=27.000,P<0.001)是肛周脓肿行切开引流术后瘘管形成的危险因素。结论性别为男性、术后未规范应用抗菌药物是肛周脓肿行切开引流术后瘘管形成的危险因素,予以规范的抗菌药物治疗可预防瘘管形成。Objective To investigate the influencing factors of fistula formation after the incision and drainage of perianal abscesses.Methods This was an observation study.The clinical data of 60 patients with perianal abscess who underwent incision and drainage treated in Panshan County People's Hospital from December 2017 to December 2019 were retrospectively analyzed,including gender,age,type of abscesses,location of abscesses,and whether antimicrobial drugs should be used regularly after surgery.All the patients underwent incision and drainage treatment,and were followed up for half a year after the operation.The patients with fistula were counted.According to whether the patients had fistula,the patients were divided into a fistula formation group and a no fistula formation group,and the influencing factors of fistula formation after the incision and drainage of perianal abscesses were analyzed.Results Among the included 60 patients,there were 30 males and 30 females,with an age of(46.68±3.75),and there were 30 cases of perianal subcutaneous abscesses,16 of ischiorectal fossa abscesses,3 of intersphincter abscesses,6 of levator ani muscle abscesses,and 5 of rectal submucosal abscesses.During the half a year follow-up,11 of the 60 patients developed fistula(18.33%).Univariate analysis showed that the formation of fistula after the incision and drainage of perianal abscesses might be affected by gender(P=0.003)and whether the postoperative antimicrobial drugs were standardized(P<0.001).The logistic regression analysis results showed that male(OR=14.500,P=0.001)and that the postoperative antimicrobial drugs were not standardized(OR=27.000,P<0.001)were risk factors for fistula formation after the incision and drainage of perianal abscesses.Conclusions Male and non-standard use of antibacterial drugs after surgery are risk factors for fistula formation after the incision and drainage of perianal abscesses.Standard antibacterial treatment can prevent fistula formation.

关 键 词：肛周脓肿 切开引流术 瘘管 影响因素 

分 类 号：R657.15[医药卫生—外科学]