单纯性肛周脓肿切开引流术后使用抗生素对肛瘘形成的影响

The effect of antibiotics on the formation of anal fistula after incision and drainage of simple perianal abscess

目的探讨单纯性肛周脓肿切开引流术后使用抗生素对术后肛瘘形成的影响。方法选取2018年3月至2019年12月单纯性肛周脓肿患者150例,随机分为抗生素组和无抗生素组,各75例。两组均行切开引流术,抗生素组术后常规使用抗生素(头孢地尼胶囊300 mg/d+甲硝唑片600 mg/d)连续口服7 d,无抗生素组术后不使用抗生素。随访3个月,统计两组肛瘘形成率。单因素χ^2检验和多因素Logistic回归分析影响切开引流术后肛瘘形成的相关指标。结果术后3个月,抗生素组肛瘘形成率显著低于无抗生素组(P<0.05)。单因素χ^2检验发现,性别、年龄、脓肿部位、术后是否使用抗生素与术后肛瘘形成差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,术后使用抗生素是单纯性肛周脓肿切开引流术后肛瘘形成的独立保护因素(P<0.05)。结论单纯性肛周脓肿切口引流术后短期内使用抗生素可能有助于降低肛瘘形成率。

Objective To investigate the effects of antibiotics on the formation of anal fistula after incisionand drainage of simple perianal abscess.MethodsFrom March 2018 to December 2019,150 patients with sim-ple perianal abscess were randomly divided into antibiotic group and non antibiotic group,with 75 cases in eachgroup.The patients in the antibiotic group were given antibiotics(cefdinir capsules 300 mg per day+metronida-zole tablets 600 mg per day)for 7 days,and the non antibiotic group were not given antibiotics.After 3-months fol-low-up,the formation rate of anal fistula was counted.χ^2 test and multivariate logistic regression were used to ana-lyze the risk factors affecting the formation of anal fistula.ResultsThree months after operation,the formationrate of anal fistula in antibiotic group was significantly lower than that in non antibiotic group(P<0.05).χ^2 testshowed that gender,age,abscess site,postoperative use of antibiotics were related to postoperative anal fistula for-mation(P<0.05).Multivariate logistic regression analysis showed that postoperative antibiotic use was an inde-pendent protective factor for developing anal fistula after incision and drainage of simple perianal abscess(P<0.05).ConclusionThe use of antibiotics for a short time after incision and drainage of simple perianal abscessmay help to reduce the formation rate of anal fistula.