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中华结直肠疾病电子杂志 ›› 2021, Vol. 10 ›› Issue (05) : 487 -491. doi: 10.3877/cma.j.issn.2095-3224.2021.05.007

论著

肛周脓肿引流术后复发或形成肛瘘的预后影响因素研究
鲁林源1,(), 朱赟1, 孙琼1, 董青军2   
  1. 1. 200233 上海交通大学附属第六人民医院中医肛肠科
    2. 200032 上海中医药大学附属龙华医院肛肠科
  • 收稿日期:2021-03-14 出版日期:2021-10-25
  • 通信作者: 鲁林源
  • 基金资助:
    上海市科学技术委员会科研课题项目(19401933000)

Prognostic factors of recurrence or anal fistula formation following the drainage of anorectal abscess

Linyuan Lu1,(), Yun Zhu1, Qiong Sun1, Qingjun Dong2   

  1. 1. Department of TCM for Anorectal Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
    2. Department of Anorectal Disease, Longhua Hospital of Shanghai University of TCM, Shanghai 200032, China
  • Received:2021-03-14 Published:2021-10-25
  • Corresponding author: Linyuan Lu
引用本文:

鲁林源, 朱赟, 孙琼, 董青军. 肛周脓肿引流术后复发或形成肛瘘的预后影响因素研究[J/OL]. 中华结直肠疾病电子杂志, 2021, 10(05): 487-491.

Linyuan Lu, Yun Zhu, Qiong Sun, Qingjun Dong. Prognostic factors of recurrence or anal fistula formation following the drainage of anorectal abscess[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(05): 487-491.

目的

本研究旨在探索导致肛周脓肿患者引流术后脓肿复发或形成肛瘘的预后影响因素。

方法

选择2017年1月至2019年12月初次发作肛周脓肿并行切开引流术的患者303例,采用多因素Cox回归分析探讨影响肛周脓肿术后脓肿复发或形成肛瘘的预后因素。

结果

随访期内所有303例患者,120例(39.6%)脓肿复发或形成肛瘘,183例(60.4%)治愈。累积治愈率1年为74.6%,2年为67.3%,3年为62.0%。女性(HR=1.759,P=0.014)、肥胖(HR=4.886,P<0.001)、马蹄形脓肿(HR=2.431,P<0.001)是肛周脓肿复发或肛瘘形成的危险因素。

结论

性别、肥胖以及是否为马蹄形脓肿这三个因素与肛周脓肿患者的预后密切相关,不同患者应采取个体化的综合防治措施,尽可能的减少脓肿复发或肛瘘的形成。

Objective

To investigate the prognostic factors leading to the recurrence of abscess or anal fistula formation in patients with anorectal abscess following the drainage.

Methods

This study included 303 subjects with first-time anorectal abscess who underwent drainage in our hospital from January 2017 to December 2019. Multivariate Cox regression analysis was used to identify the prognostic factors leading to the recurrence of abscess or anal fistula formation following the drainage.

Results

The results showed that 120 (39.6%) subjects had a recurrent or developed anal fistula and 183 (60.4%) were cured during the follow-up period. The cumulative cure rates were 74.6%, 67.3%, 62.0% for 1, 2, 3 years following the drainage, respectively. Female (HR=1.759, P=0.014), obesity (HR=4.886, P<0.001) and horseshoe abscess (HR=2.431, P<0.001) are risk factors for recurrence of anorectal abscess or anal fistula formation.

Conclusion

Gender, obesity index and horseshoe abscess are closely related to the prognosis of patients with anorectal abscess. Individualized prevention and treatment should be given for different patients to minimize the risk of recurrence of abscess or anal fistula formation.

表1 肛周脓肿预后相关因素分析
表2 肛周脓肿预后单因素Cox回归分析
表3 肛周脓肿预后多因素Cox回归分析
图1 Kaplan-Meier分析肛周脓肿术后患者累积治愈(无复发)率
图2 Kaplan-Meier分析男性与女性患者术后累积治愈(无复发)率
图3 Kaplan-Meier分析肥胖与非肥胖患者术后累积治愈(无复发)率
图4 Kaplan-Meier分析马蹄形脓肿与非马蹄形脓肿患者术后累积治愈(无复发)率
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