术前血糖、高密度脂蛋白预测肛瘘患者术后切口乙级愈合的价值  

Value of Preoperative Blood Glucose and High-density Lipoprotein in Predicting Postoperative Grade B Wound Healing in Patients with Anal Fistula

作　　者：李雪芹 刘佃温 LI Xueqin;LIU Dianwen(Department of Anorectal,Henan Shenhuo Group General Hospital,Shangqiu 476600,China)

机构地区：[1]河南神火集团总医院肛肠科,河南商丘476600

出　　处：《河南医学研究》2023年第17期3159-3162,共4页Henan Medical Research

摘　　要：目的探究肛瘘患者术前血糖、高密度脂蛋白水平对术后切口乙级愈合的预测价值。方法采用前瞻性研究,选择2022年1—12月于河南神火集团总医院拟行肛瘘切开术的肛瘘患者作为研究对象。术前术后检测患者血糖(空腹血糖、餐后2 h血糖)、高密度脂蛋白水平,常规行肛瘘切开术,以术后7 d为观察终点,统计患者术后切口乙级愈合情况,分析患者术前血糖、高密度脂蛋白水平与术后切口乙级愈合的关系,同时绘制受试者工作特征(ROC)曲线分析术前血糖、高密度脂蛋白水平对肛瘘患者术后切口乙级愈合的预测价值。结果共纳入82例肛瘘患者,术后观察发现切口乙级愈合16例,占19.51%;甲级愈合66例,占80.49%。术前及术后,乙级愈合组空腹血糖与餐后2 h血糖高于甲级愈合组,高密度脂蛋白低于甲级愈合组,差异有统计学意义(P<0.05)。经过点二列相关性分析,术前空腹血糖、餐后2 h血糖与肛瘘患者术后切口乙级愈合呈正相关(r>0,P<0.05),术前高密度脂蛋白与肛瘘患者术后切口乙级愈合呈负相关(r<0,P<0.05)。绘制ROC曲线显示,术前空腹血糖、餐后2 h血糖、高密度脂蛋白预测肛瘘患者术后切口乙级愈合的曲线下面积(AUC)>0.7,联合预测的AUC>0.8,联合预测价值更高。结论针对不伴有糖尿病及高脂血症的肛瘘患者术前血糖越高、高密度脂蛋白越低,术后切口乙级愈合的可能性越高,可以将术前血糖、高密度脂蛋白作为肛瘘患者术后切口乙级愈合的预测指标。Objective To explore the predictive value of preoperative blood glucose and high-density lipoprotein levels in patients with anal fistula to the grade B wound healing after surgery.Methods A Prospective cohort study was conducted to select the patients with anal fistula who were scheduled to undergo anal fistula incision in Henan Shenhuo Group General Hospital from January to December 2022.The levels of blood glucose(fasting blood glucose,2 hours postprandial blood glucose)and high-density lipoprotein were measured before and after operation.Anal fistula incision was performed routinely.The 7 days after operation was the end point of observation.The postoperative incision healing was counted.The relationship between preoperative blood glucose,high-density lipoprotein level and postoperative incision healing was analyzed.At the same time,the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of preoperative blood glucose and high-density lipoprotein level on postoperative incision healing in patients with anal fistula.Results A total of 82 patients with anal fistula were included,and postoperative observation showed that 16 cases(19.51%)had grade B incision healing.There were 66 cases of grade A healing,accounting for 80.49%.Before and after operation,fasting blood glucose and 2 hours postprandial blood glucose in grade B healing group were higher than those in grade A healing group,and high density lipoprotein was lower than that in grade A healing group,with a statistically significant difference(P<0.05).After point two column correlation analysis,preoperative fasting blood glucose and 2 hours postprandial blood glucose were positively correlated with grade B healing of postoperative incision in patients with anal fistula(r>0,P<0.05),and preoperative high-density lipoprotein was negatively correlated with postoperative incision healing in patients with anal fistula(r<0,P<0.05).ROC curve showed that the area under the curve(AUC)of preoperative fasting blood glucose,2 hours postp

关 键 词：肛瘘 肛瘘切开术 血糖 高密度脂蛋白 切口愈合 预测 

分 类 号：R657.16[医药卫生—外科学]