肛周坏死性筋膜炎8例临床分析

Clinical Analysis of Perianal Necrotizing Fasciitis:8 Cases Report

目的总结肛周坏死性筋膜炎的临床诊疗经验。方法回顾性分析2018年2月至2019年6月间我院收治的8例肛周坏死性筋膜炎患者的临床资料。患者均为男性,年龄26~60岁,均行急诊手术治疗,采取大切口、纵行切口、网状切口、保留皮桥、对口引流。其中1例切除睾丸,3例行二次清创,4例择期行阴囊成形术。结果本组8例患者均经手术、抗感染及综合治疗,住院时间1~103 d。1例因感染性休克及多器官功能不全死亡,7名存活患者随访8~10个月无一例复发或出现肛门功能障碍。结论准确诊断、及早手术、规范抗感染治疗及生命支持治疗可提高肛周坏死性筋膜炎患者存活率,术后对伤口进行专门护理可为其康复提供重要保障。

Objective To summary the treatment experiences of perianal necrotizing fasciitis.Methods The clinical data of 8 male patients with perianal necrotizing fasciitis(aged from 26 to 60 years old)in our hospital from February 2018 to June 2019 were analyzed retrospectively.All cases were performed surgery with open incision.Orchidectomy was carried out in one case,secondary debridement in two cases and selective scrotoplasty in four cases.Results After surgery,antibiotics treatment and comprehensive therapies,one case died of infective shock and multiple organ dysfunction syndrome and 7 cases survived.The hospital stays were one to 103 days.During 8 to 10 months follow-up,no recurrence and anus fecal incontinence was found.Conclusions Accurate diagnosis,early surgery,standardized anti-infective treatment and life support treatment can improve the survival rate of patients with perianal necrotizing fasciitis.Postoperative special nursing of wounds can provide an important guarantee for their rehabilitation.