肛瘘及肛周脓肿合并糖尿病手术治疗的可行性及效果探析  

Feasibility and effect analysis of surgical treatment of anal fistula and perianal abscess combined with diabetes mellitus

作　　者：李殿环[1] 王营[1] LI Dian-huan;WANG Ying(Jinxiang County People's Hospital,Jining 272200,China)

机构地区：[1]金乡县人民医院,272200

出　　处：《中国实用医药》2023年第14期31-35,共5页China Practical Medicine

摘　　要：目的分析肛瘘及肛周脓肿合并糖尿病手术治疗的可行性及效果。方法80例肛瘘及肛周脓肿合并糖尿病患者,根据手术方式不同分为参照组和研究组,每组40例。参照组患者行单纯切开引流术,研究组患者行根治性切开引流术。对比两组患者的临床疗效、术后康复情况、术后并发症发生率,术前1 d、术后1 d血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]水平,术前1 d、术后3 d炎性因子[白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平。结果研究组患者治疗总有效率为97.50%,高于参照组的85.00%,差异有统计学意义(P<0.05)。研究组患者术后切口愈合时间、住院时间、术后首次排气时间、术后感染控制时间分别为(14.36±3.12)、(8.65±1.36)、(1.69±0.56)、(3.12±1.05)d,均短于参照组的(27.21±3.12)、(12.36±3.24)、(3.54±0.87)、(4.36±1.12)d,差异具有统计学意义(P<0.05)。术前1 d、术后1 d,两组患者HbA1c、FBG、2 h PBG水平对比差异无统计学意义(P>0.05)。术后3 d,研究组患者TNF-α、hs-CRP、IL-6、IL-4水平分别为(3.01±1.15)ng/L、(12.18±2.15)mg/L、(232.45±10.78)ng/L、(60.36±3.45)pg/ml均低于参照组的(7.24±1.67)ng/L、(16.36±2.11)mg/L、(298.24±10.45)ng/L、(71.24±3.54)pg/ml,差异具有统计学意义(P<0.05)。研究组患者术后并发症发生率为2.50%(1/40),低于参照组的15.00%(6/40),差异有统计学意义(P<0.05)。结论对肛瘘及肛周脓肿合并糖尿病患者开展手术治疗,相较于单纯切开引流术,行根治性切开引流术的疗效、康复效果、安全性以及术后炎性因子改善效果均更佳。Objective To analyze the feasibility and effect of surgical treatment of anal fistula and perianal abscess complicated with diabetes mellitus.Methods A total of 80 patients with anal fistula and perianal abscess complicated with diabetes mellitus were divided into reference group and research group according to different surgical methods,with 40 cases in each group.The reference group received simple incision and drainage,and the research group received radical incision and drainage.Both groups were compared in terms of clinical efficacy,postoperative rehabilitation,incidence of postoperative complications,blood glucose indexes[glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),2 h postprandial blood glucose(PBG)]levels 1 d before surgery and 1 d after surgery,levels of inflammatory factors[interleukin-4(IL-4),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)]1 d before surgery and 3 d after surgery.Results The total effective rate of 97.50%in the research group was higher than that of 85.00%in the reference group,and the difference was statistically significant(P<0.05).The postoperative wound healing time,hospitalization time,first postoperative exhaust time and postoperative infection control time were(14.36±3.12),(8.65±1.36),(1.69±0.56)and(3.12±1.05)d in the research group,which were shorter than those of(27.21±3.12),(12.36±3.24),(3.54±0.87)and(4.36±1.12)d in the reference group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of HbA1c,FBG and PBG between the two groups 1 d before surgery and 1 d after surgery(P>0.05).3 d after surgery,the levels of TNF-α,hs-CRP,IL-6 and IL-4 were(3.01±1.15)ng/L,(12.18±2.15)mg/L,(232.45±10.78)ng/L and(60.36±3.45)pg/ml in the research group,which were lower than those of(7.24±1.67)ng/L,(16.36±2.11)mg/L,(298.24±10.45)ng/L and(71.24±3.54)pg/ml in the reference group,and the differences were statistically significant(P<0.05).The incidence

关 键 词：肛瘘 肛周脓肿 糖尿病 手术 疗效 康复效果 安全性 术后炎性因子 

分 类 号：R657.15[医药卫生—外科学] R587.1[医药卫生—临床医学]