D-二聚体/纤维蛋白原对肛周脓肿切开引流术后肛瘘发生的预测价值  

Role ratio of D-dimer to fibrinogen in predicting anal fistula after incision and drainage of perianal abscess

作　　者：杨彩云 Yang Caiyun(Department of Proctology,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中心医院肛肠科,驻马店463000

出　　处：《中国实用医刊》2025年第3期52-55,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨D-二聚体(D-D)/纤维蛋白原(FIB)比值(DFR)对肛周脓肿切开引流术后并发肛管直肠瘘(以下简称肛瘘)的预测价值。方法前瞻性研究。抽取2020年1月至2022年12月驻马店市中心医院收治的150例单纯肛周脓肿行切开引流手术患者。所有纳入患者术前均进行D-D、FIB检测,计算DFR。调查并记录患者资料。所有患者术后接受为期6个月的随访,记录随访期间肛瘘发生情况,并根据肛瘘发生情况分为发生组与未发生组,重点探讨DFR与肛周脓肿切开引流术后并发肛瘘的关系。绘制受试者工作特征曲线,分析DFR对术后肛瘘发生的预测价值。结果150例患者均完成随访,无失访,其中32例患者术后并发肛瘘(发生组),术后肛瘘发生率为21.33%(32/150);118例患者术后未并发肛瘘(未发生组)。术前,发生组DFR高于未发生组,深部脓肿占比高于未发生组(P<0.05)。经Logistic回归分析发现,肛周脓肿切开引流术后肛瘘的危险因素可能为术前DFR高、深部脓肿(OR>1,P<0.05)。绘制受试者工作特征曲线图结果显示,术前DFR预测肛周脓肿切开引流术后并发肛瘘的曲线下面积为0.794,预测价值中等。结论术前DFR高是肛周脓肿切开引流术后并发肛瘘的危险因素,术前早期检测患者DFR水平可用于预测肛周脓肿切开引流术后肛瘘发生风险。Objective To investigate the role of D-dimer(D-D)-fibrinogen(FIB)ratio(DFR)in prediction on development of anal fistula after incision and drainage of perianal abscess.MethodsA total of 150 patients with simple perianal abscess who underwent incision and drainage surgery in Zhumadian Central Hospital from January 2020 to December 2022 were selected for the prospective study.And they all underwent preoperative D-D and FIB testings to calculate the DFR.The clinical data were collected from the selected patients.All patients were followed up for 6 months after surgery to record the occurrence of anal fistula,with a focus on investigating the relationship between DFR and occurrence of anal fistula after incision and drainage of perianal abscess.And patients were divided into the occurrence group and the non-occurrence group according to development of anal fistula after surgery.The receiver operating characteristic curve was drawn to analyze the predictive value of DFR for postoperative anal fistula.ResultsAll the 150 patients completed follow-up without any loss of follow-up,and 32 cases developed anal fistula(occurrence group),with an incidence of 21.33%(32/150);and 118 patients did not develop anal fistula(non-occurrence group).The preoperative DFR of the occurrence group was higher,and the proportion of deep abscesses before surgery in the occurrence group was higher compared with the non-occurrence group(P<0.05).Logistic regression analysis revealed that the risk factors for anal fistula after incision and drainage of perianal abscess may be high preoperative DFR and deep abscess(OR>1,P<0.05).The results of receiver operating characteristic curve showed that the area under the curve of preoperative DFR in predicting anal fistula after incision and drainage of perianal abscess was 0.794,suggesting moderate predictive value.ConclusionsHigh preoperative DFR is a risk factor for occurrence of anal fistula after incision and drainage of perianal abscess.Early detection of DFR before surgery can be used to predict the

关 键 词：肛管直肠瘘 肛周脓肿 切开引流术 D-二聚体 纤维蛋白原 

分 类 号：R657.1[医药卫生—外科学]