肛周坏死性筋膜炎辅助检查特点及不同手术治疗效果对比分析

发布时间：2018-06-19 02:37

本文选题：筋膜炎 + 坏死性　；参考：《重庆医学》2017年02期

【摘要】：目的分析32例肛周坏死性筋膜炎的辅助检查特点及两种手术治疗效果。方法回顾性分析广西医科大学第一附属医院及广西中医药大学附属瑞康医院2005~2014年共32例肛周坏死性筋膜炎患者的临床资料,其中清创术+负压封闭引流技术(VSD)引流术组6例,单纯清创术组18例。总结两组辅助检查(白细胞计数、中性粒细胞百分比、血红蛋白、红细胞计数、清蛋白、电解质、凝血功能)的灵敏度与及其坏死感染面积的相关性,同时对比两组住院时间、手术出血量、住院费用。结果 32例患者的辅助检查中与坏死感染面积相关性有统计学意义的指标有血钙、血氯、血钠、活化部分凝血酶时间、红细胞计数、清蛋白,灵敏度大于60%的指标有血钙、白细胞计数、中性粒细胞百分比、红细胞计数、清蛋白。清创术+VSD引流术组与单纯清创术组的患者住院时间、手术时间、手术出血量差异均无统计学意义(P0.05),免疫疾病患者构成比差异有统计学意义(P0.05)。排除免疫疾病患者后,两组的住院费用差异有统计学意义(P0.05)。结论血钙、红细胞计数、清蛋白对于肛周坏死性筋膜炎有一定检测及评估价值,同时清创术+VSD引流术较单纯清创术可减少患者的住院时间及住院费用。
[Abstract]:Objective to analyze the characteristics of 32 cases of perianal necrotizing fasciitis and the results of two kinds of surgical treatment. Methods the clinical data of 32 patients with perianal necrotizing fasciitis from 2005 to 2014 in the first affiliated Hospital of Guangxi Medical University and Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine were retrospectively analyzed. There were 18 cases in debridement group. To summarize the correlation between sensitivity and necrotic infection area of the two groups (leukocyte count, neutrophil percentage, hemoglobin, erythrocyte count, albumin, electrolyte, coagulation function), and to compare the length of hospitalization between the two groups. Surgical bleeding, hospital expenses. Results among the 32 patients, the indexes related to the area of necrotic infection were blood calcium, blood chlorine, blood sodium, activated partial thrombin time, red blood cell count, albumin, blood calcium with sensitivity more than 60%. White blood cell count, percentage of neutrophils, red blood cell count, albumin. There was no significant difference in the hospitalization time between the VSD drainage group and the pure debridement group, and there was no significant difference in the amount of blood loss between the two groups (P 0.05), but there was significant difference in the constitution ratio of the patients with immune diseases (P 0.05). The difference of hospitalization cost between the two groups was statistically significant (P 0.05) after immune disease was excluded. Conclusion Serum calcium, red blood cell count and albumin are valuable in detecting and evaluating perianal necrotic fasciitis. Debridement with VSD drainage can reduce the hospitalization time and hospitalization cost of patients compared with simple debridement.
【作者单位】：广西中医药大学附属瑞康医院胃肠肛门外科;广西医科大学第一附属医院结直肠肛门外科;
【基金】：广西自然科学基金面上项目(2013GXNSFAA019153)
【分类号】：R657.1

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