Brunet C, Delpero J R, Guerinel G, Geissler A, Barthélémy A, Sainty J M, Thirion X, Grégoire R
Hôpitaux Sud, Marseille.
Chirurgie. 1992;118(10):607-13; discussion 614.
From 1988 to 1992, 50 cases of perineal gangrene were treated with a therapeutic protocol combining: a) repeated extensive excisions, b) hyperbaric oxygen therapy, even before surgery if this was possible, and c) intensive care. The mortality rate was 24% (12/50). It was even higher in patients admitted more than 6 hours after diagnosis. The average stay in hospital was of 20 (+/- 2) days. Four patients presented with residual signs. Twenty-eight (56%) had had colostomy for lesions originating in the rectum or threatening the anal margin; 9 of these patients died, while gastrointestinal continuity was restored in another 17 cases. There were three predictive factors of survival in this series: a) early diagnosis and treatment, b) severity index on admission, c) some associations of bacteria.
1988年至1992年期间，对50例会阴坏疽患者采用了以下综合治疗方案：a）反复广泛切除；b）高压氧治疗，若可能，甚至在手术前进行；c）重症监护。死亡率为24%（12/50）。诊断后6小时以上入院的患者死亡率更高。平均住院时间为20（±2）天。4例患者有残留体征。28例（56%）因直肠病变或危及肛门边缘而行结肠造口术；其中9例患者死亡，另外17例患者恢复了胃肠道连续性。本系列中有三个生存预测因素：a）早期诊断和治疗；b）入院时的严重程度指数；c）某些细菌的组合。
