关于弗尔涅坏疽预后因子的探讨(附15例报告)

Discussion on prognostic factors in Fournier gangrene(Report of 15cases)

目的：总结诊疗弗尔涅坏疽的临床经验,初步探讨该疾病的早期诊断,分析可能影响预后的相关因子,并对评估其预后的常用测算工具进行比较。方法：回顾性分析2004~2012年间在我院确诊为弗尔涅坏疽并进行手术治疗的15例患者临床资料,使用统计学方法分析影响预后的相关因子,对评估预后的常用测算工具进行对比。结果：15例患者均为男性,11例生存（生存组）,4例死亡（死亡组）。最常见的并发症为糖尿病。死亡组与生存组的红细胞压积、血钠的差异有统计学意义（P〈0.05）,可作为其预测因子;评估预后的测算工具中,乌洛达弗尔涅坏疽严重性指数（UFGSI）在生存者与死亡者中的差异有统计学意义（P〈0.05）。结论：感染波及腹壁、高龄、低血钠、较低红细胞压积与弗尔涅坏疽较高的死亡率相关,评估预后的评分工具UFGSI能对其预后作出较好评价。

Objective：To summarize our experience in diagnosis and treatment of Fournier gangrene （FG）, to discuss the early diagnosis of FG, to analyze the related factors that affect the prognosis of FG, and to compare prognostic tool to evaluate the severity of FG. Method：A retrospective study of 15 patients with FG diagnosed and surgically treated in our hospital from 2004 to 2012 was taken. Statistical method was used to analyze the prognostic factors of FG and to compare prognostic tools for evaluation of the severity of FG. Result： All 15 male patients were divided into survival group （11 cases） and death group （4 cases）. The commonest complication was diabetes mellitus. The laboratory parameters of hematocrit and serum sodium showed significant differences between survival and death group （P〈0.05）. They could be used as predictors. Uludag Fournier Gangrene Severity Index （UFGSI） as a prognostic tool for evaluation the severity of FG had significant differences between survival and death group （P〈0.05）. Conclusion：We think that infection of abdominal wall, older age, low serum sodium and low hematocrit are associated with high mortality of FG. UFGSI as a scoring tool can better evaluate the prognosis of FG.