肛瘘术后创面愈合质量与患者便秘史、营养状况、合并症相关性

The Correlation between the Quality of Wound Healing after Anal Fistula Surgery and the Patient’s Constipation History,Nutritional Status,and Comorbidities

目的分析肛瘘术后创面愈合质量与患者便秘史、营养状况及合并症相关性。方法回顾性分析2018年1月—2020年4月在该院完成肛瘘术治疗及随访患者72例的临床资料,统计患者肛瘘术后创面愈合质量并统计创面愈合不良的患者例数,分析肛瘘术后创面愈合质量与患者便秘史、营养状况、合并症的相关性。结果72例肛瘘患者中术后创面愈合不良17例,发生率为23.61%(17/72);愈合不良者性别、年龄、体质量指数(BMI)与愈合良好者比较,差异无统计学意义(P>0.05);17例愈合不良患者中有15例患者既往有便秘史,55例愈合良好的患者中有29例患者既往有便秘史,愈合不良便秘史占比高于愈合良好,差异有统计学意义(χ^(2)=6.890,P=0.009);17例愈合不良的患者中共16例营养状况不良,55例愈合良好的患者中有33例营养状况不良,愈合不良中营养状况不良占比高于愈合良好,差异有统计学意义(χ^(2)=6.953,P=0.008);17例愈合不良的患者中存在合并症患者共14例,55例愈合良好患者中存在合并症患者共23例,愈合不良中存在合并症的占比高于愈合良好,差异有统计学意义(χ^(2)=8.541,P=0.004);经Logistic回归分析结果显示,肛瘘患者便秘史、营养状况不良、存在合并症是术后创面愈合质量不良的影响因素(OR=6.724、10.667、6.493,P=0.017、0.027、0.007)。结论肛瘘患者的便秘史、营养状况不良、存在合并会对术后创面愈合质量造成影响,增加创面愈合不良的风险,故术前充分了解患者自身情况,并进行合理干预,对患者肛瘘术后创面愈合具有一定的积极意义。

Objective To analyze the correlation between the quality of wound healing after anal fistula surgery and the patient's constipation history,nutritional status and comorbidities.Methods The clinical data of 72 patients who completed the treatment and follow-up of anal fistula surgery in the hospital from January 2018 to April 2020 were retrospectively analyzed.The quality of wound healing after anal fistula operation and the number of patients with poor wound healing were counted.The correlation between the quality of wound healing after anal fistula surgery and the patient's constipation history,nutritional status,and comorbidities.Results Among 72 patients with anal fistula,17 had poor wound healing after operation,the incidence was 23.61%(17/72);there was no statistically significant difference in gender,age,and body mass index(BMI)between poorly healed patients and well-healed patients(P>0.05);15 of the 17 patients with poor healing had a history of constipation,and 29 of the 55 patients with good healing had a history of constipation.The proportion of the history of poor healing with constipation was higher than that of good healing,and the difference was statistically significant.(χ^(2)=6.890,P=0.009);16 of the 17 patients with poor healing were malnourished,and 33 of the 55 well-healed patients were malnourished,and the proportion of malnourished in malhealing was higher than that of well-healed,the difference was statistically significant(χ^(2)=6.953,P=0.008);there were 14 cases of comorbidities in the 17 cases of poor healing,23 cases of comorbidities in the 55 cases of well-healing patients,and comorbidities in poor healing.The proportion of symptoms was higher than that of good healing,and the difference was statistically significant(χ^(2)=8.541,P=0.004);the Logistic regression analysis showed that the history of constipation,malnutrition,and comorbidities in patients with anal fistula were the poor quality of postoperative wound healing(OR=6.724,10.667,6.493,P=0.017,0.027,0.007).Conclusion The history of constipation,malnutrition,and the combination of anal fistula patients will affect the quality of postoperative wound healing and increase the risk of poor wound healing.Therefore,fully understand the patient’s own condition before surgery and carry out reasonable interventions,which has certain positive significance for wound healing after anal fistula operation.