全程外科干预在肛周坏死性筋膜炎治疗中的应用体会——附1例病例报告

The Experience on Around Treatment Course Surgical Intervention Applied in the Treatment of Perianal Necrotizing Fascitis:A Case Report

为总结全程外科干预在肛周坏死性筋膜炎(PNF)治疗中的经验。回顾性分析本院救治的5例PNF患者临床资料,分析初始治疗的应急处置及手术方法,术后创面处理措施及必要的再次手术情况。结果显示,5例PNF患者均经急诊手术清创,术中彻底清除坏死组织,术后积极换药,必要时再次手术清创治愈。其中1例阴囊坏死患者后期行阴股沟转移皮瓣阴囊重建术。5例患者均治愈出院,随访1个月至4年,无复发及其他相关并发症和后遗症。结果表明,早期手术,彻底清创,术后积极换药引流,保持创面清洁,必要时再次手术清创或二期重建,是治疗PNF的关键。

In order to summarize the experience about around treatment course surgical intervention applied in the treatment of perianal necrotizing fascitis(PNF),authors retrospectively analysed the clinical data of 5 PNF patients treated in author’s hospital:the emergency management and procedures when primary treatment,postoperative measurement on wound-surface,and status on necessary secondary surgery.As results,the 5 cases had all received emergency operative debridement,intraoperatively completely clearancing necrotizing tissue,actively postoperative dressing exchange,as well as secondary procedure’s de’bridement and cure if necessarily;among them,1 case with scrotum necrosis received reconstruction procedure of scrotum via groin transfer flap;the 5 cases were cured and discharged,a follow-up of 1 months-4 years did not find recurrence,as well as other related complication and sequela.Results show that early operation,complete de’bridement,actively postoperative dressing exchange,and keep wound-surface clean,if necessarily secondary operative de’bridement or two-stage reconstruction,are the key of treatment.