Fournier坏疽急诊治疗12例的5年经验报道

Five years experience of Fournier＇s gangrene emergency treatment of 12 cases in single centre

目的总结Fournier坏疽的临床特点及急诊治疗的原则及预后。方法回顾性分析2006—2011年首都医科大学附属北京友谊医院泌尿外科急诊收治的Fournier坏疽患者12例，所有患者均急诊进行清创术，并给予静脉广谱抗生素＋局部创面清创换药十全身综合治疗，分析其临床特点、诊疗过程及预后。结果12例患者均为男性，平均年龄67．7岁，初始病变部位均位于阴囊，平均清创次数3．8次，平均住院时间29．7d。12例患者均利用阴囊剩余皮肤完成阴囊重建，2例尿道大范围缺损患者行经会阴尿道造口术。死亡2例（16．7％），10例平均随访57个月，未见复发。结论Fournier坏疽仍然是目前泌尿外科临床急症之一，重症患者病死率超过50％，需要谨慎对待，应采取抗生素、局部清创和全身支持的综合治疗以提高治愈率。

Objecitve To conclude the clinical manifestation of Fournier＇s gangrene （FG） and its emergency treatment. Methods From 2006 to 2011, 12 patient were involved in the study, all had received debridement, wide spectrum antibiotics and support therapy, the clinical manifestation, treatment choice and prognosis were ana- lyzed retrospectively. Results All patients were male with 67.7 year- old mean age. Initial lesions were all in scro- tal skin, an average procedures of each patient was 3.5, mean hospitalization days was 29.7 days. Surgical wound was healed by left serotal skin in all eases, 2 cases with huge urethra defect were received perineostomy. Ten cases were survived with 57-months follow-up and mortality was 16.7%. Conclusions Fournier is one of emergency disease of Urology. Its mortality is still high. Intensive care and appropriate anti- biotic therapy combined with surgi- cal treatment is the key of FG＇s management.