肛周急性坏死性筋膜炎18例临床分析

Clinical analysis of 18 cases of perianal acute necrotizing fasciitis

目的分析肛周急性坏死性筋膜炎的临床特点、检查、治疗方法及转归等。方法回顾性分析肛周急性坏死性筋膜炎18例临床资料,通过手术和药物治疗后,观察患者转归情况。结果 18例中男15例,女3例,有基础疾病者15例。所有患者白细胞均明显升高,最高的达26.38×109∕L。18例患者均给予手术治疗,术后给予抗生素、治疗原发疾病、营养支持和中药治疗等。18例中放弃治疗2例,治愈16例。16例患者平均住院时间为56d,随访6个月无复发。结论肛周急性坏死性筋膜炎发展迅速,进展快,病死率高,应早期诊断,早期手术,合理应用抗生素,加强营养支持等全身综合性治疗,可获良效。

Objective To analyze the clinical features, examination, treatment and outcome of perianal acute necrotizing fasciitis. Methods The clinical data of 18 cases of perianal acute necrotizing fasciitis were analyzed retrospectively, and the outcome of the patients was observed after operation and drug treatment. Results Among the 18 cases, 15 were male, 3 were female, and 15 had basic diseases. White blood cells of all patients were increased significantly, the highest of 26.38 × 10^9/L. After surgical treatment, 18 patients were treated with antibiotics, primary disease, nutritional support and traditional Chinese medicine. Of the 18 cases, 2 were given up treatment, and the other 16 were cured. The average hospitalization time of 16 patients was 56d, andno recurrence was found in the follow-up period of 6 months. Conclusion Perianal acute necrotizing fasciitis has rapid development, rapid progress, high mortality, many basic diseases and poor systemic symptoms. Early diagnosis, early operation, rational application of antibiotics, active basic disease treatment and nutritional support can achieve satisfactory results.