影响肛瘘术后创面愈合质量的危险因素分析

An Analysis on the Risk Factors Influencing Wound-surface Healing Quality after Anal Fistula Surgery

目的:探讨影响肛瘘术后创面愈合质量的危险因素。方法:收集2020年1月至2022年1月于我科接受手术治疗的144例肛瘘患者资料,包括一般资料、手术资料及术后恢复情况,根据术后创面愈合质量分为创面愈合不良组(32例)和创面愈合良好组(112例),比较2组患者资料,分析影响创面愈合质量的危险因素。结果:与创面愈合不良组相比,创面愈合良好组患者年龄更小,术前营养不良及合并糖尿病、肠炎、便秘者比例更低,保留括约肌手术者比例更高,术后并发局部血肿、创口感染率更低,且术后大便性状方面更好,P<0.05。Logistic多因素回归分析显示,术前营养不良、合并糖尿病及术后并发创口感染、大便性状不佳是影响肛瘘术后创面愈合质量的独立危险因素,P<0.05。结论:影响肛瘘术后创面愈合质量的危险因素较多,如营养不良、合并糖尿病、术后创口感染、大便形状不佳,临床工作中应注意患者的营养补给、血糖控制,加强术后创口管理、大便性状管理。

Objective To explore the risk factors influencing wound-surface healing quality after anal fistula surgery.Methods Reviewed the data of 144 anal fistula patients treated surgically in author’s hospital(2020-01-2022-01),including common data,operative data,and postoperative recovered status,according to healing quality divided them into healing bad group(32 cases)and fine group(112 cases);then,compared both groups’data,so as to analyse the risk factors.Results Compared to bad group in fine group,patients’age,more smaller;the ratio of who suffered from preoperative inanition and associated DM,enteronitis and constipation more lower;the ratio of who underwent saving-sphincter surgery,more higher;the incidence of postoperatively associated with local hematoma,more lower;wound infection rate,more lower;and,postoperative stool-character,more better(P<0.05).Logistic multi-variate regression analysis showed preoperative inanition(1),associated DM(2),postoperatively associated wound infection(3),and bad stool-characters(4)were indepedent risk factors influencing wound-surface healing quality after surgery(P<0.05).Conclusion There are many rsik factors influencing wound-surface healing quality,such as(1),(2),(3)and(4),therefore,clinically it should be to notice nutrition support on the patients,control their blood glucose,strength wound managment after surgery,as well as stool-character management.