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目的 探讨Fournier坏疽的诊断及治疗。 方法 对 16例男性Fournier坏疽患者的临床资料进行分析。患者年龄 2 4～ 84岁 ,平均 5 1岁。其中阴囊坏疽 13例 ,阴茎皮肤坏疽 3例。细菌培养 14例 ,阳性 9例。 16例均行外科清创、引流、抗感染等治疗 ,4例行高压氧治疗。 结果 13例经二期缝合痊愈出院 ,其中 2例 1个月后取皮瓣行阴茎、阴囊成形术。死亡 3例 ,其中 2例并发败血症 ,1例高龄患者早期出现肾功能受损而致多器官功能衰竭。 结论 治疗以早期广泛清创及应用广谱抗生素为主 ,加强局部引流 ,有条件者可行高压氧治疗。
Objective To investigate the diagnosis and treatment of Fournier gangrene. Methods Clinical data of 16 male patients with Fournier gangrene were analyzed. Patients aged 24 to 84 years, mean 51 years old. Including scrotum gangrene in 13 cases, 3 cases of penile skin gangrene. Bacterial culture in 14 cases, positive in 9 cases. Sixteen patients underwent surgical debridement, drainage, anti-infection and other treatment, 4 patients underwent hyperbaric oxygen therapy. Results Thirteen patients were cured by two sutures and discharged. Two of them were treated with penis and scrotoplasty after 1 month. Three died, of which two cases of septicemia, one case of elderly patients with early renal impairment caused by multiple organ failure. Conclusion The treatment of early extensive debridement and the application of broad-spectrum antibiotics, to strengthen the local drainage, conditional feasible hyperbaric oxygen therapy.