CAJ | 학술논문

目的总结Fournier坏疽的临床特点及急诊治疗的原则及预后.方法回顾性分析2006-2011年首都医科大学附属北京友谊医院泌尿外科急诊收治的Fournier坏疽患者12例,所有患者均急诊进行清创术,并给予静脉广谱抗生素+局部创面清创换药+全身综合治疗,分析其临床特点、诊疗过程及预后.结果 12例患者均为男性,平均年龄67.7岁,初始病变部位均位于阴囊,平均清创次数3.8次,平均住院时间29.7 d.12例患者均利用阴囊剩余皮肤完成阴囊重建,2例尿道大范围缺损患者行经会阴尿道造口术.死亡2例(16.7％),10例平均随访57个月,未见复发.结论 Fournier坏疽仍然是目前泌尿外科临床急症之一,重症患者病死率超过50％,需要谨慎对待,应采取抗生素、局部清创和全身支持的综合治疗以提高治愈率.
목적 총결Fournier배저적림상특점급급진치료적원칙급예후.방법 회고성분석2006-2011년수도의과대학부속북경우의의원비뇨외과급진수치적Fournier배저환자12례,소유환자균급진진행청창술,병급여정맥엄보항생소+국부창면청창환약+전신종합치료,분석기림상특점、진료과정급예후.결과 12례환자균위남성,평균년령67.7세,초시병변부위균위우음낭,평균청창차수3.8차,평균주원시간29.7 d.12례환자균이용음낭잉여피부완성음낭중건,2례뇨도대범위결손환자행경회음뇨도조구술.사망2례(16.7％),10례평균수방57개월,미견복발.결론 Fournier배저잉연시목전비뇨외과림상급증지일,중증환자병사솔초과50％,수요근신대대,응채취항생소、국부청창화전신지지적종합치료이제고치유솔.
Objecitve To conclude the clinical manifestation of Fournier's gangrene (FG) and its emergency treatment.Methods From 2006 to 201 1,12 patient were involved in the study,all had received debridement,wide spectrum antibiotics and support therapy,the clinical manifestation,treatment choice and prognosis were analyzed retrospectively.Results All patients were male with 67.7 year-old mean age.Initial lesions were all in scrotal skin,an average procedures of each patient was 3.5,mean hospitalization days was 29.7 days.Surgical wound was healed by left scrotal skin in all cases,2 cases with huge urethra defect were received perineostomy.Ten cases were survived with 57-months follow-up and mortality was 16.7％.Conclusions Fournier is one of emergency disease of Urology.Its mortality is still high.Intensive care and appropriate anti-biotic therapy combined with surgical treatment is the key of FG's management.