Jarboui Slim, Jarraya Hichem, Daldoul Sami, Sayari Sofiène, Moussa Mounir Ben, Abdesselem Mohamed Morched, Zaouche Abdeljelil
Service de chirurgie viscérale, CHI de Poissy, F-78303 Poissy Cedex, France.
Presse Med. 2008 May;37(5 Pt 1):760-6. doi: 10.1016/j.lpm.2007.08.018. Epub 2008 Jan 4.
The objective of this retrospective study of 35 cases of perineal gangrene was to describe their clinical and therapeutic features and to analyze the prognostic factors of mortality.
From 1997 to 2004, 35 cases (25 men and 10 women, mean age=50.3 years) with perineal gangrene were treated in the "A" surgical department of Charles Nicole Hospital (Tunisia) with a combination of intensive care, antibiotic therapy, extensive excision and drainage, repeated if necessary and colostomy.
The mortality rate was 17.1%. The mean duration of hospitalization was 15.3 (range: 2-64) days. One patient had anal incontinence as sequelae. The colostomy in two patients was closed at the 9(th) and the 13(th) month. Statistical analysis showed that the extent of cellulitis, presence of myonecrosis, occurrence of septic shock need for postoperative mechanical ventilation, and IGSII and FGSIS severity scores differed significantly between patients who survived and those who died.
Perineal gangrene is still a very severe disease. The initial anatomic lesions, the IGSII and FGSIS severity scores and postoperative complications are the main prognostic factors of mortality.
本回顾性研究对35例会阴坏疽病例进行分析，旨在描述其临床及治疗特征，并分析死亡的预后因素。
1997年至2004年期间，突尼斯查尔斯·尼科尔医院“A”外科收治了35例会阴坏疽患者（25例男性，10例女性，平均年龄50.3岁），采用重症监护、抗生素治疗、广泛切除与引流（必要时重复进行）以及结肠造口术相结合的治疗方法。
死亡率为17.1%。平均住院时间为15.3天（范围：2 - 64天）。1例患者出现肛门失禁后遗症。2例患者的结肠造口分别在第9个月和第13个月闭合。统计分析表明，存活患者与死亡患者在蜂窝织炎范围、是否存在肌坏死、是否发生感染性休克、术后是否需要机械通气以及IGSII和FGSIS严重程度评分方面存在显著差异。
会阴坏疽仍然是一种非常严重的疾病。初始解剖学病变、IGSII和FGSIS严重程度评分以及术后并发症是死亡的主要预后因素。
