阴囊坏疽12例临床分析

Clinical analysis of 12 cases of scrotum gangrene

目的总结阴囊坏疽的临床特点,提高诊治水平.方法对12例阴囊坏疽患者的临床资料进行回顾性分析,本组12例患者平均年龄(66.67±11.99)岁,FGSI评分(4.58±3.26),UFGSI评分(7.92±4.81).75%合并2型糖尿病(9/12).58.3%影像学发现皮下气体(7/12).58.3%培养出2种及以上致病菌(7/12).结果本组12例患者治疗后均好转,无死亡病例.诊治过程中,4例术后转入ICU,其中2例发生感染性休克.阴囊创面7例通过换药、2例封闭式负压引流+游离皮肤移植、2例二期缝合、1例游离皮肤移植,均愈合良好.结论科学的病情评估和早期外科清创,抗感染同时注重全身支持治疗,外加多学科协作,是诊治阴囊坏疽的重点.

Objective To summarize clinical characteristics of scrotum gangrene and improve its diagnosis and treatment.Methods Clinical data of 12 patients with scrotum gangrene were retrospectively analyzed.Their mean age was(66.67±11.99)years,mean FGSI score was(4.58±3.26),and mean UFGSI score was(7.92±4.81).Of 12 patients,nine patients(75%)were combined with type 2 diabetes mellitus.Subcutaneous gas was found by imaging examination in seven patients(58.3%),and two and more pathogenic bacteria were identified in seven patients(58.3%).Results All the patients were recovered after treatment.In the course of treatment,four patients were transferred to ICU after operation,septic shock occurred in two patients.For treatment of scrotal wound,seven patients were managed with conventional dressings,two patients with vacuum assisted closure(VAC)therapy and free skin transplantation,two patients with secondary suture,and one patient with free skin transplantation,they all healed well.Conclusion Scientific condition assessment,early surgical debridement,broad-spectrum antibiotic coverage while giving systemic support treatment,and multidisciplinary cooperation,are all crucial for better prognosis and survival.