Etiology Of Perianal Abscess

Objective :By comparing the levels of serum androgen,the content of androgen receptor and the number of anal glands in patients with perianal abscess and mixed hemorrhoids,the role of these factors in the occurrence of perianal abscess was studied,and the risk factors of perianal abscess were found out,and the methods of prevention and non-surgical treatment of the disease were explored.Methods:1.From May 2017 to May 2018,patients with perianal abscess,anal fistula and mixed hemorrhoids were admitted to the second Department of general surgery of Qingdao Municipal Hospital.Surgery(eighth edition)points out that most anal fistulas are caused by perianal abscess,which breaks itself into an external orifice leading to the skin.Therefore,anal fistula belongs to perianal abscess and can be jointly included in the study group.Hemorrhoids is one of the most common anorectal diseases.The supporting structure of anal cushion,venous plexus and arteriovenous anastomotic branches are pathologically altered or displaced,which can occur at any age.The incidence of hemorrhoids increases with age.The occurrence and development of hemorrhoids are not the same as perianal abscess or anal fistula and are common in clinic.They are set as control group.Referring to inclusion and exclusion criteria,112 patients in the study group were collected,including 89 males and 23 females,with an average age of 37.75(+11.2)and a median age of 34 years(18-63).The control group consisted of 84 patients,including 43 males and 41 females,with an average age of 38.32(+10.64)and a median age of 37 years(18-63).Observing indicators: The levels of serum androgen and estrogen? the expression of androgen receptors in anal glands and anal glands in the dentate line of anal canal.2.On the basis of the above study,risk factors analysis increased a number of cases according to inclusion and exclusion criteria.116 patients in the experimental group were collected,including 96 males and 20 females,with an average age of 38.52±11.15(18~65)years.118 patients in the control group(mainly mixed hemorrhoids),including 60 males and 58 females,with an average age of 41.28±14.84(18~65)years.Observation Indicators: Age,sex,personality,get angry,acne,alcohol consumption,smoking,fatigue,defecation habits,BMI,pepper consumption.Results :1.1 The levels of serum androgen in the study group were lower than those in the control group at all ages(P < 0.05),and the levels of androgen in the study group aged40-49 and 50-63 were significantly lower than those in the control group(P < 0.01).The level of serum androgen in female study group was lower than that in control group(P <0.05)in 30-39 years old group,but there was no significant difference between 18-29 years old and 40-45 years old group(P > 0.05).1.2 There was no significant difference in estrogen level between the two groups(P > 0.05).1.3 The results of the study on anal gland and androgen receptor were influenced by the location of operation and the condition of sampling.78 samples of the study group and 70 samples of the control group were collected.The positive rate of anal gland in thestudy group was 25.6%,which was much lower than that in the control group(57.1%,P <0.05).1.4 The results of the study on anal gland and androgen receptor were influenced by the location of operation and the condition of sampling.78 samples of the study group and 70 samples of the control group were collected.The positive rate of anal gland in the study group was 25.6%,which was much lower than that in the control group(57.1%,P <0.05).2.“Get angry”,Spicy food,Fatigue and High BMI(regression coefficient = 1.721,1.127,0.793,1.794,P = 0.0001,0.002,0.21,0.0001)had significant effects on the incidence of perianal abscess.Other factors such as smoking,drinking and defecation habits also had effects on the incidence of perianal abscess,but they were not independent risk factors.Conclusion:1.1 In adult male patients with perianal abscess,the serum androgen level decreased and the expression of androgen receptor increased.In female patients with perianal abscess,the change was not obvious.1.2 We believe that there is a mechanism or axis of androgen-androgen receptor-anal gland reaction in human body.The increase of androgen or any link of androgen receptor in human body will lead to excessive secretion of anal gland.The chance of anal gland obstruction increases greatly when excessive secretion occurs,which is easy to cause infection.This mechanism is applicable to the vast majority of patients with perianal abscess of anal origin.2.“Get angry”,Spicy food,Fatigue,and High BMI are independent risk factors for perianal abscess.The above factors can affect the level of serum androgen and cause the overloaded operation of the anal gland.Smoking,drinking,defecation habits and other factors unrelated to androgen secretion are not related to the incidence of perianal abscess,perhaps because they can not affect the level of androgen.