Prospective study of healing time after hemorrhoidectomy
Prospective study of healing time after hemorrhoidectomy
复制标题
痔切除术后愈合时间的前瞻性研究
DOI：
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发表时间：
1999
影响因子：
3.9
通讯作者：
Emilio Trabucchi
中科院分区：
文献类型：
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作者：
E. Morandi;D. Merlini;A. Salvaggio;D. Foschi;Emilio Trabucchi
目的：痔疮和直肠疾病在hiv阳性患者中非常常见，特别是在有同性恋习惯的患者中。本研究旨在比较此类患者的痔疮后切除术愈合时间，并评估与hiv阳性状态相关的各种因素的作用。方法：该研究纳入了1992年至1996年间接受痔疮切除术的48例男性患者（32例hiv血清阳性，16例获得性免疫缺陷综合征）的前瞻性研究；20例年龄匹配和性别匹配的血清阴性患者作为回顾性对照。记录愈合时间、术后并发症、创面感染情况，并评价CD4+、Karnofsky指数评分、hiv核糖核酸的延缓作用。组间差异分析采用Cox模型、Student'st检验、卡方检验和Fisher精确概率检验。P值<0.05认为有统计学意义。结果：Cox's模型显示，HIV阳性和获得性免疫缺陷综合征的存在显著延迟了伤口愈合，这也与感染的存在相关。艾滋病毒阳性患者的治愈率在14周后为66%，在32周后为100%；获得性免疫缺陷综合征患者的相应数字为0%和50%。对照组均于14周后痊愈（P<0.01vs）。获得性免疫缺陷综合征患者和HIV阳性患者)。疾病控制和预防中心hiv阳性状态（包括CD4+计数）和表现状态被证明具有预后价值。结论：我们的数据表明，获得性免疫缺陷综合征患者痔疮切除术的适应症需要非常仔细地考虑，因为伤口延迟愈合的发生率很高。
PURPOSE: Hemorrhoids and rectal diseases are very frequent in HIV-positive patients, especially in those with homosexual habits. This study was designed to compare posthemorrhoidectomy healing time in such patients, and evaluate the role of various factors related to their HIV-positive status. METHODS: The study involved a prospective series of 48 male patients (32 HIV-seropositive and 16 with acquired immunodeficiency syndrome) who underwent hemorrhoidectomy between 1992 and 1996; 20 agematched and gender-matched seronegative patients were retrospectively identified as controls. Healing times, post-operative complications, and wound infections were recorded, and the delaying effect of CD4+, Karnofsky Index scores, and HIV-ribonucleic acid were evaluated. Between-group differences were analyzed using Cox's model, Student'st-test, chi-squared test, and Fisher's exact probability test.P values of <0.05 were considered statistically significant. RESULTS: Cox's model revealed that HIV positivity and the presence of acquired immunodeficiency syndrome significantly delayed wound healing, which also correlated with the presence of infection. The healing rate in HIV-positive patients was 66 percent after 14 weeks and 100 percent after 32 weeks; the corresponding figures for patients with acquired immunodeficiency syndrome were 0 and 50 percent. All of the controls were healed after 14 weeks (P<0.01vs. both the patients with acquired immunodeficiency syndrome and HIV+ patients). Centers for Disease Control and Prevention HIV-positive status (including CD4+ counts) and the performance status proved to be of prognostic value. CONCLUSIONS: Our data suggest that the indications for hemorrhoidectomy in patients with acquired immunodeficiency syndrome need to be considered extremely carefully because of the high incidence of delayed wound healing.