肛瘘栓填塞治疗经括约肌型肛瘘的长期愈合率及影响肛瘘愈合的因素分析

Long-term healing rate and influencing factors of transsphincteric anal fistula treated with anal fistula plug

目的分析肛瘘栓填塞治疗经括约肌型肛瘘的长期愈合率及肛瘘愈合的影响因素。方法回顾性选取2020年1月至2022年8月盐城市第三人民医院经括约肌型肛瘘治疗中肛瘘栓填塞治疗患者60例,采用单因素和多因素分析肛瘘的愈合情况及影响因素。结果肛瘘栓填塞治疗经括约肌型肛瘘患者60例肛瘘愈合40例,未愈合20例,愈合率为66.67%。单因素分析显示,肛瘘愈合和肛瘘未愈合患者的性别、年龄、体重指数、血小板计数、白细胞计数、白蛋白水平、糖尿病病史、吸烟史、酗酒史之间的差异无统计学意义(P>0.05),肛瘘愈合组患者的肛瘘病程<6个月比率为35.00%,高于肛瘘未愈合患者(10.00%),肛瘘外口与肛缘距离为(2.41±0.36)cm,小于肛瘘未愈合患者[(2.84±0.80)cm],血红蛋白水平为(153.46±9.24)g/L,低于肛瘘未愈合患者[(166.91±9.06)g/L],差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,经括约肌型肛瘘治疗中肛瘘栓填塞治疗患者60例肛瘘愈合影响因素包括肛瘘病程(OR=3.185,95%CI=1.360~7.464,P<0.05),不包括肛瘘外口与肛缘距离、血红蛋白水平(P>0.05)。结论肛瘘栓填塞治疗经括约肌型肛瘘的长期愈合率高,肛瘘愈合的影响因素包括肛瘘病程、肛瘘外口与肛缘距离、血红蛋白水平,其中肛瘘病程是独立影响因素。

Objective To analyze the long-term healing rate of anal fistula plug in the treatment of transsphincteric anal fistula and the influencing factors of anal fistula healing.Methods From January 2020 to August 2022,60 patients with anal fistula embolization in the treatment of sphincteric anal fistula in Yancheng Third People’s Hospital were retrospectively selected.Univariate analysis was performed to analyze the healing status and influencing factors of anal fistula in 60 patients with anal fistula embolization in the treatment of sphincteric anal fistula.Multivariate Logistic regression analysis was used to analyze the influencing factors of anal fistula healing in 60 patients with transsphincteric anal fistula treated with anal fistula plug.Results In 60 patients with anal sphincter type anal fistula,40 cases were healed and 20 cases were not healed.The healing rate was 66.67%.There were no significant differences in gender,age,body mass index,platelet count,white blood cell count,albumin level,history of diabetes,history of smoking and history of alcoholism between patients with and without anal fistula healing(P>0.05).The rate of anal fistula duration<6 months in patients with anal fistula healing group was 35.00%,which was higher than that in patients with non-healing anal fistula,the distance between the external mouth of anal fistula and the anal edge was(2.41±0.36)cm,which was smaller than that of patients with non-healing anal fistula[(2.84±0.80)cm],the level of hemoglobin was(153.46±9.24)g/L,which was lower than that in patients with non-healing anal fistula[(166.91±9.06)g/L],the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the influencing factors of anal fistula healing in 60 patients with anal sphincter type anal fistula treatment included the course of anal fistula(OR=3.185,95%CI=1.360-7.464,P<0.05),excluding the distance between the external mouth of anal fistula and the anal margin and the level of hemoglobin(P>0.05).Conclusion The long-term healing rate is high in the treatment of transsphincteric anal fistula with anal fistula plug.The influencing factors of anal fistula healing include the course of anal fistula,the distance between the external mouth of anal fistula and the anal margin,and the level of hemoglobin,the course of anal fistula is an independent influencing factor.