肠造口术可降低福尼尔坏疽患者的死亡率。
Enterostomy can decrease the mortality of patients with Fournier gangrene.
作者信息
Li Yan-Dong, Zhu Wei-Fang, Qiao Jian-Jun, Lin Jian-Jiang
机构信息
Yan-Dong Li, Jian-Jiang Lin, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
出版信息
World J Gastroenterol. 2014 Jun 28;20(24):7950-4. doi: 10.3748/wjg.v20.i24.7950.
AIM
To determine the significance of enterostomy in the emergency management of Fournier gangrene.
METHODS
The clinical data of 51 patients (49 men and 2 women) with Fournier gangrene who were treated at our hospital over the past 12 years were retrospectively analyzed. The patients were divided into two groups according the surgical technique performed: enterostomy combined with debridement (the enterostomy group, n = 28) or debridement alone (the control group, n = 23). Patients in the enterostomy group received thorough debridement during surgery and adequate local drainage after surgery, as well as administration of broad-spectrum antibiotics. The clinical data and outcomes in both groups were analyzed.
RESULTS
The surgical procedures were successful in both patient groups. In the enterostomy group, 10 (35.8%) patients required skin grafting with a total of six debridement procedures. While in the control group, six (26.1%) patients required four debridement procedures. However, this difference was not statistically significant. Following surgery, the time to normal body temperature (6 d vs 8 d, P < 0.05) and average length of hospital stay (14.3 ± 7.8 d vs 20.1 ± 8.9 d, P < 0.05) were shorter in the enterostomy group. The case fatality rate was lower in the enterostomy group than that in the control group (3.6% vs 21.7%, P < 0.05).
CONCLUSION
Enterostomy can decrease the case fatality rate of patients with Fournier gangrene.
目的
确定肠造口术在福尼尔坏疽急诊处理中的意义。
方法
回顾性分析我院过去12年收治的51例福尼尔坏疽患者（49例男性，2例女性）的临床资料。根据所采用的手术技术将患者分为两组：肠造口术联合清创术（肠造口术组，n = 28）或单纯清创术（对照组，n = 23）。肠造口术组患者在手术期间接受彻底清创，术后进行充分的局部引流，并给予广谱抗生素治疗。分析两组的临床资料和结果。
结果
两组患者的手术均成功。肠造口术组有10例（35.8%）患者需要植皮，共进行了6次清创手术。而对照组有6例（26.1%）患者需要进行4次清创手术。然而，这种差异无统计学意义。术后，肠造口术组体温恢复正常的时间（6天对8天，P < 0.05）和平均住院时间（14.3±7.8天对20.1±8.9天，P < 0.05）较短。肠造口术组的病死率低于对照组（3.6%对21.7%，P < 0.05）。
结论
肠造口术可降低福尼尔坏疽患者的病死率。
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