阴囊Fournier坏疽的临床分析(附14例报告)

Clinical analysis of Fournier's gangrene of scrotum(Report of 14 cases)

目的:探讨阴囊Fournier坏疽的临床特点、诊治方法及预后。方法:对我院2012年1月~2016年6月收治的14例阴囊Fournier坏疽患者的临床资料进行回顾性分析。结果:本组患者年龄为26~70岁,平均年龄48岁;6例合并2型糖尿病,3例合并肝硬化;原发于阴囊2例,继发于肛周脓肿12例。所有患者均行清创手术,积极的抗感染、支持治疗和换药处理;5例死亡,9例痊愈;1例直接缝合创缘,1例经长期换药后创面愈合,7例行重建手术。结论:早期清创手术和积极的抗感染治疗仍是处理阴囊Fournier坏疽的关键,创面的综合处理可以减少甚至避免重建手术,白蛋白可能成为预测Fournier坏疽预后的有效指标。

Objective：To investigate the clinical features,diagnosis,treatment and prognosis of Fournier＇s gangrene of scrotum.Method：From January,2012 to June,2016,14 patients with Fournier＇s gangrene of scrotum were retrospectively analyzed about the clinical characteristics and therapeutic methods.Result：The patients were aged 26-70（mean,48）years old.Six patients were complicated by diabetes and three were liver cirrhosis.Twelve cases originated from perianal infection with later involvement of the surround in skin soft tissues.Aggressive surgical debridement,incision drainage and broad-spectrum antibiotic medication were administered,and scrotal plasty was performed for seven cases.Nine of them recovered and the other five（35.7%）died of infectious shock,pulmonary infection or multiple organ failure after surgery.Conclusion：Timely aggressive surgical debridement and broad-spectrum antibiotic medication are essential for the treatment of Fournier＇s gangrene of scrotum.Conservative treatment based on the use of wound care,negative pressure wound therapy,hyperbaric oxygen therapy can eliminate the need for reconstruction.Albumin may be an effective predictor of prognosis of Fournier＇s gangrene.