坏死性筋膜炎作为手术清创治疗的2型糖尿病控制不佳患者的罕见并发症：一例报告及文献综述
Fournier's gangrene as a rare complication in patient with uncontrolled type 2 diabetes treated with surgical debridement: A case report and literature review.
作者信息
Provenzano D, Lo Bianco S, Zanghì M, Campione A, Vecchio R, Zanghì G
机构信息
Department of General Surgery and Medical-Surgical Specialties, Policlinico - Vittorio Emanuele Hospital, University of Catania, Italy.
Department of General Surgery and Medical-Surgical Specialties, Policlinico - Vittorio Emanuele Hospital, University of Catania, Italy.
出版信息
Int J Surg Case Rep. 2021 Feb;79:462-465. doi: 10.1016/j.ijscr.2021.01.098. Epub 2021 Jan 30.
INTRODUCTION
Fournier's gangrene is a potentially fatal emergency condition, supported by an infection of perineal and perianal region, characterized by necrotizing fasciitis with a rapid spread to fascial planes. FG, usually due to compromised host, may be sustained by many microbial pathogens.
CASE REPORT
A 66-year-old man, with a history of uncontrolled type 2 diabetes, obesity with BMI 38, chronic kidney failure and chronic heart failure, was admitted to the Emergency Department with a large area of necrosis involving the perineal and perianal regions.
DISCUSSION
Fournier's gangrene is favoured by hypertension, obesity, chronic alcoholism, renal and heart failure. Generally, Fournier's gangrene needs other procedures in addition to wound debridement such as colostomy, cystostomy, or orchiectomy.
CONCLUSION
We report a case of FG found as complication in a patient with uncontrolled type 2 diabetes, treated with effective combination therapy with surgical debridement and antibiotics infusion.
引言
福尼尔坏疽是一种潜在致命的紧急情况，由会阴和肛周区域感染引起，其特征为坏死性筋膜炎并迅速蔓延至筋膜平面。福尼尔坏疽通常由于宿主抵抗力下降，可由多种微生物病原体引起。
病例报告
一名66岁男性，有2型糖尿病控制不佳、肥胖（BMI为38）、慢性肾衰竭和慢性心力衰竭病史，因会阴和肛周区域大面积坏死入住急诊科。
讨论
高血压、肥胖、慢性酒精中毒、肾衰竭和心力衰竭易引发福尼尔坏疽。一般来说，福尼尔坏疽除伤口清创外还需要其他手术，如结肠造口术、膀胱造口术或睾丸切除术。
结论
我们报告一例在2型糖尿病控制不佳的患者中发现的福尼尔坏疽并发症病例，采用手术清创和抗生素输注的有效联合疗法进行治疗。
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