肛周坏死性筋膜炎57例诊治分析  

Diagnosis and Treatment of 57 Cases of Perianal Necrotizing Fasciitis

作　　者：蒋静[1] 张亚锋[1] 刘宁 杜文武[1] 陈伟[1] 杨元红[1] 何毅 姚文春 袁永鑫 JIANG Jing;ZHANG Ya-feng;LIU Ning;DU Wen-wu;CHEN Wei;YANG Yuan-hong;HE Yi;YAO Wen-chun;YUAN Yong-xin(Suining Central Hospital,Suining,Sichuan 629000)

机构地区：[1]遂宁市中心医院,四川遂宁629000

出　　处：《中国肛肠病杂志》2024年第1期24-27,共4页Chinese Journal of Coloproctology

基　　金：遂宁市中医药管理局科研项目(No:SN2021B17)。

摘　　要：目的:回顾性分析肛周坏死性筋膜炎实验室风险指数,探索实验室风险指数与其他影响因素的相关性,总结肛周坏死性筋膜炎的特点。方法:收集2019年1月至2022年6月我院肛肠科收治的57例肛周坏死性筋膜炎患者临床资料,并对所有患者进行坏死性筋膜炎实验室风险指数评分以及风险分级,比较不同实验室风险级别患者平均年龄、合并脓毒血症及糖尿病、病死率的区别。结果:57例患者中低危42例,中危9例,高危6例;低危患者平均年龄低于中危、高危患者(P<0.05);中危患者与高危患者平均年龄比较差异无统计学意义(P>0.05);糖尿病患者低危占比低于非糖尿病患者(P<0.05),而中危、高危占比均高于非糖尿病患者(P<0.05);脓毒血症低危患者占比低于中危、高危患者占比(P<0.05),中危脓毒血症患者占比低于高危患者占比(P<0.05)。结论:肛周坏死性筋膜炎实验室风险级别与年龄、基础疾病、并发症等有一定关系,可以评估发生坏死性筋膜炎、脓毒血症几率以及预后情况,可以作为肛周坏死性筋膜炎的严重程度评价指标之一。Objective To retrospectively analyze the laboratory risk index of perianal necrotizing fasci-itis,and to explore the correlation between laboratory risk index and other influencing factors,and to sum-marize the characteristics of perianal necrotizing fasciitis.Methods The clinical data of 57patients with perianal necrotizing fasciitis admitted to the Anorectal Department of our hospital from January 2019to June 2022were collected,and the laboratory risk index score and risk ranking of necrotizing fasciitis were performed on all the patients.The average age,sepsis,diabetes mellitus(DM)and mortality of patients with different laboratory risk levels were compared.Results Among the 57patients,42were at low risk,9were at medium risk and 6were at high risk.The mean age of low-risk patients was lower than those of medium-risk and high-risk patients(P<0.05).There was no significant difference in the mean age between medium-risk and high-risk patients(P>0.05).The low-risk proportion of diabetic patients was lower than that of non-diabetic patients(P<0.05),and the proportions of medium-risk and high-risk of diabetic patients were higher than that of non-diabetic patients(P<0.05).The proportion of low-risk patients with sepsis was lower than those of medium-risk and high-risk patients(P<0.05).The propor-tion of medium risk patients with sepsis was lower than that of high-risk patients(P<0.05).Conclu-sion The laboratory risk level of perianal necrotizing fasciitis is related to the age,underlying diseases and complications,etc.It can be used to evaluate the probability and prognosis of necrotizing fasciitis and sep-sis,and can be used as one of the evaluation indicators of the severity of perianal necrotizing fasciitis.

关 键 词：肛周坏死性筋膜炎 实验室风险指数 基础疾病 并发症 

分 类 号：R657.1[医药卫生—外科学]