Villanueva-Sáenz E, Martínez Hernández-Magro P, Valdés Ovalle M, Montes Vega J, Alvarez-Tostado F J F
Colon and Rectum Surgery Department, Dr. Bernardo Sepúlveda Specialty Hospital, National Medical Center of the 21st Century, Mexican Institute for Social Security, Mexico City, Mexico.
Tech Coloproctol. 2002 Apr;6(1):5-10; discussion 11-3. doi: 10.1007/s101510200001.
We report our experience and results in the management of Fournier's gangrene. Fournier's gangrene is a synergistic infective necrotizing fasciitis, which involves perianal, perineal and genital regions, originated mostly from colorectal and genitourinary sources. Charts and records from 28 patients with Fournier's gangrene diagnosed between 1993 and 1997 were reviewed. The mean patients age was 57.8 years (range, 22-82 years); mean hospital stay was 19 days. Eighteen patients (64.3%) were diabetic. The most common source of gangrene was ischiorectal abscess in 22 patients (78.6%). Colostomy was performed on 14 patients (50%) and cystostomy on 7 patients (25%). Ten patients (35.7%) died because of sepsis. In conclusion, medical and surgical treatment should be aggressive. Colostomy should only be performed if sphincter complex is damaged. Multidisciplinary management is mandatory, because of high morbidity and mortality.
我们报告了我们在福尼尔坏疽治疗方面的经验和结果。福尼尔坏疽是一种协同感染性坏死性筋膜炎，累及肛周、会阴和生殖器区域，主要起源于结直肠和泌尿生殖系统。回顾了1993年至1997年间诊断为福尼尔坏疽的28例患者的病历和记录。患者平均年龄为57.8岁（范围22 - 82岁）；平均住院时间为19天。18例患者（64.3%）患有糖尿病。坏疽最常见的来源是坐骨直肠窝脓肿，共22例患者（78.6%）。14例患者（50%）进行了结肠造口术，7例患者（25%）进行了膀胱造口术。10例患者（35.7%）因败血症死亡。总之，医疗和手术治疗应积极进行。只有在括约肌复合体受损时才应进行结肠造口术。由于高发病率和死亡率，多学科管理是必要的。
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