糖尿病对肛周脓肿发生、发展及预后影响的研究OA
Effect of diabetes mellitus on the occurrence,progression,and prognosis of perianal abscess
目的 探讨糖尿病与肛周脓肿临床特征的关联性,明确糖尿病在疾病演变过程中的作用机制,为合并糖尿病的肛周脓肿患者提供个体化治疗策略.方法 选取2023年6月至2024年6月于湘潭市中心医院中西医结合肛肠科住院治疗的肛周脓肿患者255例,根据是否合并糖尿病分为糖尿病组(46例)和普通组(209例).比较两组基线资料、临床特征、住院天数、创面愈合时间、肛周红肿消失时间、3个月随访预后、病原菌分布及药物敏感性.结果 糖尿病组肛周脓肿为深部脓肿者占比为69.57%(32/46),高于普通组的39.71%(83/209),差异有统计学意义(χ2=13.570,P<0.001).糖尿病组创面愈合时间显著长于普通组[(12.57±3.56)d比(10.99±2.70)d;t值为2.811,P<0.001].糖尿病组肛周脓肿占比高于普通组,无脓肿及肛瘘占比低于普通组(P<0.05).221例细菌培养阳性样本中,主要检出大肠埃希菌、肺炎克雷伯菌、咽峡炎链球菌及厌氧性脆弱拟杆菌等致病性微生物.不同病原体在两组间的分布模式及耐药谱存在异质性.结论 糖尿病可加剧肛周脓肿严重程度并延长伤口愈合时间,基于病原学检测结果选择敏感抗生素具有必要性.
Objective To investigate the correlation between diabetes mellitus and the clinical characteristics of perianal abscess,clarify the mechanism of action of diabetes mellitus in the disease evolution process,and provide individualized treatment strategies for patients complicated with diabetes mellitus.Methods A total of 255 patients with perianal abscess who were hospitalized in the Department of Integrated Chinese and Western Medicine for Anorectal Disease,Xiangtan Central Hospital from June 2023 to June 2024 were enrolled.According to the presence or absence of complicated diabetes mellitus,they were divided into the diabetes group(46 cases)and the non-diabetes group(209 cases).The baseline data,clinical characteristics,length of hospital stay,wound healing time,disappearance time of perianal erythema and swelling,3-month follow-up prognosis,pathogen distribution,and drug sensitivity were compared between the two groups.Results The proportion of deep abscesses in the diabetes group was 69.57%(32/46),which was significantly higher than that in the non-diabetes group(39.71%,83/209),with a statistically significant difference(χ2=13.570,P<0.001).The wound healing time in the diabetes group was significantly longer than that in the non-diabetes group[(12.57±3.56)days vs.(10.99±2.70)days;t=2.811,P<0.001].The proportion of perianal abscess recurrence was higher than that in the non-diabetes group,while the proportions of non-abscess and anal fistula were lower than those in the non-diabetes group(P<0.05).Among the 221 bacterial culture-positive samples,the main pathogenic microorganisms detected were Escherichia coli,Klebsiella pneumoniae,Streptococcus anginosus and anaerobic Bacteroides fragilis.There were heterogeneities in the distribution patterns and drug resistance profiles of different pathogens between the two groups.Conclusions Diabetes mellitus can exacerbate the severity of perianal abscess and prolong wound healing time.It is imperative to select sensitive antibiotics based on the results of etiological tests.
胡华;文茂;刘小球
湘潭市中心医院(湖南大学附属医院)中西医结合肛肠科,湖南 湘潭 411100湘潭市中心医院(湖南大学附属医院)中西医结合肛肠科,湖南 湘潭 411100湘潭市中心医院(湖南大学附属医院)中西医结合肛肠科,湖南 湘潭 411100
肛周脓肿糖尿病耐药率病原菌
perianal abscessdiabetes mellitusdrug resistance ratepathogenic bacteria
《感染、炎症、修复》 2026 (2)
156-160,5
湘潭市医学科研项目(2023-xtyx-31)
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