肛瘘栓填塞治疗经括约肌型肛瘘的长期愈合率及影响愈合的因素分析

The Long-term Healing Rate of Anal Fistula Plug in the Treatment of Transsphincteric Anal Fistula and Analysis of Factors Affecting Healing

目的 观察肛瘘栓填塞治疗经括约肌型肛瘘的长期愈合率并且分析影响愈合的相关因素。方法 回顾性分析本院在2017年6月-2018年6月收治的100例进行肛瘘栓填塞治疗经括约肌型肛瘘患者的临床资料,观察100例患者治疗前后的肛门括约肌功能评分变化并且对其进行为期三年的随访统计其肛瘘愈合情况,根据其愈合情况将其分为A组(愈合)和B组(未愈合),对可能影响其肛瘘愈合的相关因素进行单因素分析和多因素Logistic回归分析。结果 100例患者治疗前的肛门括约肌功能评分为(1.41±0.19)分,治疗1个月、3个月以及6个月的肛门括约肌功能评分分别为(4.84±1.77)分、(2.59±0.96)分、(1.55±0.60)分,治疗后肛门失禁情况相对较为轻微。100例患者随访时间平均(36.85±3.71)个月,其中共计54例患者肛瘘愈合,长期愈合率为54.00%。相较于A组,B组性别、年龄、糖尿病史、白细胞计数、血小板计数、白蛋白水平、酗酒史以及体质指数比较差异均无统计学意义(P>0.05);相较于A组,B组肛瘘病程明显更长,血红蛋白水平明显更高,肛瘘外口距肛缘明显更远,差异均有统计学意义(P<0.05)。多因素Logistic回归分析中结果显示影响肛瘘栓填塞治疗后愈合的独立危险因素为肛瘘病程≥6个月(P<0.05)。结论 在经括约肌型肛瘘患者的临床治疗中,肛瘘栓填塞治疗具有较为良好的治疗效果,长期疗效肯定,影响肛瘘栓填塞治疗后愈合的独立危险因素为肛瘘病程≥6月,为改善患者预后宜尽早实施治疗。

Objective To observe the long-term healing rate of anal fistula embolization in the treatment of transsphincteric anal fistula and analyze the related factors that affect the healing.Methods To retrospectively analyze the clinical data of 100 patients treated with anal fistula embolization in our hospital from June 2017 to June 2018 for the treatment of transsphincteric anal fistula,observe the changes in the anal sphincter function scores of 100 patients before and after treatment and carry out a period of time.Three-year follow-up statistics of the healing of his anal fistulas were divided into group A(healed)and group B(unhealed)according to their healing conditions,and univariate analysis and multivariate logistic regression analysis of related factors that might affect the healing of their anal fistulas were carried out.Results The anal sphincter function scores of 100 patients before treatment were(1.41±0.19)points,and the anal sphincter function scores of one month,three months,and six months of treatment were(4.84±1.77)points,(2.59±0.96)points,(1.55±0.60)points,the anal incontinence after treatment is relatively mild.The average follow-up time of 100 patients was(36.85±3.71)months,of which 54 patients healed anal fistula,and the long-term healing rate was 54.00%.Compared with group A,there was no significant difference in gender,age,diabetes history,white blood cell count,platelet count,albumin level,history of alcoholism and body mass index in group B(P>0.05);compared with group A,B In the group,the course of anal fistula was significantly longer,the hemoglobin level was significantly higher,and the external orifice of the anal fistula was significantly farther from the anal margin,and the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that the independent risk factor that affected the healing of anal fistula embolization treatment was the duration of anal fistula≥6 months(P<0.05).Conclusion In the clinical treatment of patients with transsphincteric anal fistula,the treatment of anal fistula embolization has a relatively good therapeutic effect,and the long-term effect is positive.The independent risk factor that affects the healing of anal fistula embolization treatment is the course of anal fistula≥6 months.Implement treatment.