ObjectiveTo investigate the expressions of stromal cell-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) in local tissues of perianal abscess and their relationships with clinicopathological features and prognosis of patients.MethodsA total of 47 patients with perianal abscess (perianal abscess group) and 58 patients with mixed hemorrhoids (mixed hemorrhoids group) were selected for the study. The tissues were collected during the operation. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expressions of SDF-1 mRNA and CXCR4 mRNA in local tissues of the two groups, the positive expressions of SDF-1 protein and CXCR4 protein in local tissues were detected by immunohistochemistry, and the relationships between the expressions of SDF-1 and CXCR4 protein and the clinical characteristics, prognosis of patients were analyzed.ResultsThe expression levels of SDF-1 mRNA and CXCR4 mRNA in the perianal abscess group were higher than those in the mixed hemorrhoids group, and the positive rates of SDF-1 protein and CXCR4 protein in the perianal abscess group were higher than those in the mixed hemorrhoids group too (P<0.05). The expressions of SDF-1 protein and CXCR4 protein in perianal abscess tissues were both not related to sex, age, location of abscess, and course of disease (P>0.05), but was related to abscess diameter, healing time, and anal fistula (P<0.05). The non-recurrence rates of SDF-1 protein-negative group and CXCR4 protein-negative group were lower than those of SDF-1 protein-positive group and CXCR4 protein-positive group respectively (P<0.05).ConclusionSDF-1 and CXCR4 molecular are up-regulated in the local tissues of perianal abscess, which are related to the size of abscess, healing time, anal fistula, and recurrence of patients.
Objective To evaluate the clinical effect of vacuum sealing drainage (VSD) technology in the treatment of high perianal abscess. Methods A total of 38 cases of high perianal abscess who underwent surgery in our hospital from May. 2014 to Feb. 2016 were randomly divided into 2 groups: the VSD group (n=19) and the control group (n=19). The cases of VSD group were performed with closure of internal orifice+VSD technique, and the cases of control group were treated with radical operation of perianal abscess (low incision combined with high thread operation). The following indexes of cases in 2 groups were compared and analyzed, including postoperative pain score, wound healing time, postoperative anal function score, and prognosis. Results There were significant differences in pain score (3.53±0.70vs. 5.11±0.74), postoperative anal function score (0vs. 1), and wound healing time〔(27.58±4.95) dvs. (44.68±6.53) d〕between VSD group and control group,P<0.05. Compared with the control group, the pain score and anal function score of the VSD group were both lower, and the wound healing time was shorter. However, there was no statistically significant difference in incidence of fistula between the two groups〔5.3% (1/19)vs. 15.8% (3/19),P=0.60〕. Conclusion In the treatment of high perianal abscess, VSD technology can relieve pain in patients, shorten the wound healing time, protect the anal function, and the prognosis is as well as low incision combined with high thread operation, so VSD is a better treatment method for high perianal abscess.
目的 觀察AQUACEL-Ag?親水性纖維敷料對肛周膿腫患者術后創面愈合的作用。方法 將49例肛周膿腫術后患者按隨機數字表法隨機分為試驗組（25例）和對照組（24例），分別予AQUACEL-Ag?親水性纖維敷料換藥（1 次/3d）和無菌凡士林紗布換藥（1次/d），并觀察2組患者的換藥時創面疼痛程度、創面愈合時間、創面換藥次數、創面愈合率及換藥時創面分泌物培養結果。結果 試驗組在創面疼痛、愈合時間、創面換藥次數及換藥時分泌物培養轉陰時間方面均優于對照組（P＜0.05）；動態監測創面愈合率：第3d時2組間比較差異無統計學意義（P＞0.05），第9、15、21d時試驗組創面愈合率明顯高于對照組（P＜0.05）。結論 從本組有限的數據看，AQUACEL-Ag?親水性纖維敷料對肛周膿腫患者術后創面愈合有重要作用。
Objective To investigate the early diagnosis and effective treatment of Fournier syndrome. Methods The clinical data of 385 patients with perianal abscess in this hospital between 2006 and 2009 were retrospectively analyzed for screening the patients with complication of Fournier syndrome. Results Fournier syndrome was detected in 6 patients （1.56%）， who were all cured by treating with early incision and drainage, complete debridement, effective antibiotics, and supporting therapy. Conclusions Perianal abscess can induce Fournier syndrome of perineal, genital, and abdominal wall regions, which spreads rapidly and progressively, so early diagnosis and extensive surgical debridement play a decisive role on the prognosis.
目的 探討保留括約肌虛掛線法治療高位肛周膿腫的臨床療效。 方法 2009年10月－2010年10月采用隨機對照試驗，對52例高位肛周膿腫患者施行手術治療，其中保留括約肌虛掛線法（治療組）26例，切開掛線引流法（對照組）26例。對兩組患者術后6個月肛瘺發生率、切口愈合時間、術后1～15 d每晚疼痛視覺模擬評分（VAS）和術后6個月痊愈患者肛門功能后遺癥發生率進行比較。 結果 術后6個月，治療組和對照組肛瘺發生率分別為4.0%和3.8%，差異無統計學意義（P＞0.05）。術后7～15 d治療組VAS評分均低于對照組，差異有統計學意義（P＜0.05）。兩組切口愈合時間分別為（19.05 ± 6.71）d和（21.42 ± 8.40）d，差異有統計學意義（P＜0.05）。術后6個月治療組痊愈患者肛門功能全部正常，對照組后遺癥發生率為12.0%，兩組比較差異有統計學意義（P＜0.05）。 結論 保留括約肌虛掛線治療在術后疼痛、切口愈合時間和保護肛門功能等方面明顯優于切開掛線引流治療，是一種治療高位肛周膿腫較為理想的方法。
目的 探討一期后位切開掛線左右側切開引流手術治療高位馬蹄型肛周膿腫的臨床效果。方法 前瞻性納入2008年10月至2010年10月期間慶陽市人民醫院收治的60例高位馬蹄型肛周膿腫患者，將其隨機分成2組，其中觀察組30例，行一期后位切開掛線左右側切開引流術；對照組30例，行一期切開掛線術。比較2組患者的臨床療效。結果 臨床療效觀察組為優11例（36.67%），良17例（56.66%），差2例（6.67%），優良率為93.33%（28/30）；對照組為優5例（16.67%），良16例（53.33%），差9例（30.00%），優良率為70.00%（21/30）。觀察組的臨床療效優于對照組（P＜0.05）。觀察組患者術后肛緣水腫、肛門前移和肛門內陷的發生率以及創面愈合時間均低于或短于對照組（P＜0.05）。2組患者術后均獲訪1年，均無復發，肛門功能均正常，無畸形。結論 一期后位切開掛線左右側切開引流術治療高位馬蹄型肛周膿腫的臨床療效確切，患者術后恢復良好，值得臨床推廣應用。