藏毛窦发病率和远期复发率现况及其影响因素分析

Trends in incidence and long-term recurrence rate of pilonidal sinus disease and analysis of associated influencing factors

目的调查德国部队中藏毛窦的发病率和术后远期复发率的现状及其发展变化趋势，分析不同手术治疗方法、体格状况和吸烟量等因素对藏毛窦的发病率和术后远期复发率的影响。方法对德国三家部队医院1980至1996年收治的所有藏毛窦患者的资料进行统计，随机抽取其中500例患者进行随访。结果德国部队中藏毛窦的发病率由1985年的0．3／1000上升到2007年的2．4／1000。随机抽取的500例患者中2例死亡，498例接受了随访。其术后复发率从1981年的33％，到1986年的23％，再到1996年的12％，呈明显下降趋势（P=0．01）。藏毛窦切除后行开放愈合的复发率为16．8％，显著低于行一期缝合的复发率31．0％（P〈0．01）。部队中人均体质量每十年增加1kg，德国国民人均体质量每十年增加1．9kg，但是体质量的增加与藏毛窦复发率之间无显著相关性（P=0．72）。每天吸烟20支以上者藏毛窦的复发率比吸烟≤20支者显著升高（P=0．015）。结论在藏毛窦的术后复发率下降，特别是切除后开放愈合的术后复发率下降的同时，藏毛窦的发病率上升了近十倍。

Objectives To investigate the trends in incidence and long-term recurrence rate of pilonidal sinus disease （ PSD ） within the German Armed Forces, and analyse the influence of variable factors, such as different surgical methods,body constitution and smoking amount,to incidence and long-term recurrence rate of PSD. Methods Information of all the patients being admitted with primary PSD to the surgical departments of three hospitals of the German Armed Forces between 1980 and 1996 was collected and analyzed,500 patients of which were interviewed. Results Two of the 500 patients were dead, and every one of the rest 498 patients agreed to take part in the interview. The incidence of PSD rose from 0. 3/ 1000 in 1985 to 2.4/1000 in 2007. The recurrence rates were decreasing within 16 years of treatment from 33% in 1981 via 23% in 1986 to 12% in 1996 （ P = 0. 01 ）. Recurrence rates of primary open wound healing （16. 8% ） compared to primary suture （31.0%） differ significantly （P 〈 0. 01 ）. While the mean body weight within the army rose 1 kg per decade, population shows an increase of 1.9 kg per decade though not being an influencing factor on the recurrence rate （ P = 0. 72 ）. Smoking of more than 20 cigarettes per day proved to be a significant factor on the recurrence rate of PSD （P = 0. 015 ）. Conclusion While the recurrence rates-especially of primary open wound treatment-decreased, the incidence of PSD rose nearly tenfold.