Canbaz Hakan, Cağlikülekçi Mehmet, Altun Uğur, Dirlik Musa, Türkmenoğlu Ozgür, Taşdelen Bahar, Aydin Süha
Department of General Surgery, Mersin University, Faculty of Medicine, Mersin, Turkey.
Ulus Travma Acil Cerrahi Derg. 2010 Jan;16(1):71-6.
Fournier's gangrene (FG) is a rapidly progressive, polymicrobial, synergistic necrotizing fasciitis, and the mortality rate is still high. We aimed to determine the risk factors affecting prognosis and treatment cost.
Eighteen patients operated for FG during 2003-2007 were investigated retrospectively. Surviving and exitus groups were compared regarding demographic data, etiological factors, laboratory findings, treatment modality, length of hospital stay, and treatment cost.
Mean age was 54.5 years, and the female/male ratio was 6/12. Mortality was observed in 6 (33.3%) patients and was significantly high among females (66.6%) (p=0.035). Mean duration of complaint in the exitus group (9+/-3 days) was higher than in survivors (5+/-3 days) (p=0.018). The most frequent comorbid disease was diabetes (39.2%), the most frequent etiology was perianal abscess (55.6%) and the primary location of infection was anorectal region (61.1%). Hyponatremia was significantly high in surviving patients (p=0.039). Mean of FG severity point in the exitus group (6.83) was higher than in survivors (3.17) (p=0.011). The most frequently cultivated microorganism, Escherichia coli (66.6%), was significantly high in the exitus group (p=0.012). The mean number of debridements was 4.67. Fecal diversion was performed in 7 (38.8%) patients. Hospital stay in the surviving group (34.17 days) was higher than in the exitus group (10.50 days) (p=0.002). Treatment cost between groups was indifferent (p>0.05).
Female gender, duration of complaint, FG severity point, and cultivated microorganism (E. Coli) were thought to affect mortality. FG is a disease that might cause extended hospital stay and high treatment cost.
福尼尔坏疽（FG）是一种快速进展的、多微生物协同性坏死性筋膜炎，死亡率仍然很高。我们旨在确定影响预后和治疗费用的危险因素。
回顾性调查了2003年至2007年间因FG接受手术的18例患者。比较了存活组和死亡组的人口统计学数据、病因、实验室检查结果、治疗方式、住院时间和治疗费用。
平均年龄为54.5岁，男女比例为6/12。6例（33.3%）患者死亡，女性死亡率显著较高（66.6%）（p=0.035）。死亡组的平均主诉持续时间（9±3天）高于存活组（5±3天）（p=0.018）。最常见的合并症是糖尿病（39.2%），最常见的病因是肛周脓肿（55.6%），感染的主要部位是肛门直肠区域（61.1%）。存活患者低钠血症显著较高（p=0.039）。死亡组的FG严重程度评分平均值（6.83）高于存活组（3.17）（p=0.011）。最常培养出的微生物大肠杆菌（66.6%）在死亡组中显著较高（p=0.012）。平均清创次数为4.67次。7例（38.8%）患者进行了粪便转流。存活组的住院时间（34.17天）高于死亡组（10.50天）（p=0.002）。两组之间的治疗费用无差异（p>0.05）。
女性、主诉持续时间、FG严重程度评分和培养出的微生物（大肠杆菌）被认为会影响死亡率。FG是一种可能导致住院时间延长和治疗费用高昂的疾病。
