封闭式负压引流技术治疗Fournier坏疽的临床疗效

Clinical efficacy of vacuumsealing drainage in treatment of Fournier's gangrene

目的:观察应用封闭式负压引流技术治疗Fournier坏疽的临床效果.方法:选取杭州师范大学医学院附属余杭医院2013-09/2014-09收治的40例坏疽患者作为研究对象,将其随机分作观察组20例与对照组20例,观察组予以封闭式负压引流技术进行治疗,对照组予以常规外科清创的治疗,比较两组患者的Fournier坏疽严重程度指数(Fournier's gangrene severity index,FGSI)、清创次数、体温恢复时间、治愈情况及住院时间.结果:治疗后7、14 d观察组FGSI均较对照组低(P<0.05),观察组平均清创次数为3.8次,明显少于对照组,且观察组体温恢复早于对照组,观察组20例患者均治愈,其中17例创口局麻下行二期缝合后愈合,3例行腹股沟皮瓣转移后愈合,对照组16例治愈出院,4例死亡;观察组平均住院时间明显较对照组短(P<0.05).结论:封闭式负压引流技术是治疗Fournier坏疽的一种有效方法,值得临床推广.

AIM： To assess the clinical effects of vacuumsealing drainage technology in the treatment of Fournier＇s gangrene. METHODS： Forty patients with Fournier＇s gangrene treated from September 2013 to September 2014 at our hospital were randomly divided into either an observation group or a control group. The observation group was treated by vacuum-sealing drainage, and the control group was treated by conventional debridement.Fournier＇s gangrene severity index（FGSI）,debridement frequency, time to body temperature recovery, healing situation and hospitalizationtime were compared for the two groups. RESULTS： FGSI on days 7 and 14 after treatment was significantly lower in the observation group than in the control group（P 〈0.05）. The average debridement times in the observation group was 3.8, significantly less than that in the control group（P 〈0.05）. Body temperature recovery was faster in the observation group（P 〈0.05）. All the 20 patients in the observation group were cured, including 17 cases of wound healing after secondary suture under local anesthesia and 3 cases of healing after inguinal flap grafting. Sixteen patients in the control group were cured, and 4 cases died. The hospitalization time was significantly shorter in the observation group（P 〈0.05）. CONCLUSION： Vacuum-sealing drainage is an effective method for the treatment of Fournier＇s gangrene.