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福尼尔坏疽:伊本·鲁西德大学医院中心内脏外科急诊服务七年经验

Fournier's gangrene: Seven years of experience in the emergencies service of visceral surgery at Ibn Rochd University Hospital Center.

作者信息

Bensardi F Z, Hajri A, Kabura Sylvestre, Bouali M, El Bakouri A, El Hattabi K, Fadil A

机构信息

Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.

Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco.

出版信息

Ann Med Surg (Lond). 2021 Oct 30;71:102821. doi: 10.1016/j.amsu.2021.102821. eCollection 2021 Nov.

Abstract

INTRODUCTION

This work aims to describe and discuss the epidemiological, clinical, therapeutic and evolution of Fournier's gangrene.

MATERIALS AND METHODS

Case series with retrospective data collection of patients treated for Fournier's gangrene between January 2010 and March 2017. The main etiologies, risk factors, postoperative complications outcomes and long term follow up results were analyzed.

RESULTS

Eight four (84) patients were recruited. The average age of our patients was 49 years (with limits of 20-76), the male gender dominates our series (83.33%) with a sex ratio of 5 M/1W, the most frequently found risk factor was diabetes mellitus (37%). The most common etiology was anal abscesses (32%). The average time to consultation was 8 days (limits ranges from 3 to 30 days). All patients were admitted at a necrosis stage (100%). Anemia was identified in 85% of cases. The low platelets were noticed in 44.03% of cases. Hypoalbuminemia was found in 93% of cases. All patients (100%) benefited resuscitation initially and antibiotic therapy on their admission. They received emergency surgical debridement with a cleansing stoma. The average length of hospital stay was 13 days and complications occurred in 33% of cases. The mortality rate was 7.14%.

CONCLUSION

Fournier's gangrene is a medico-surgical emergency with a high morbidity and mortality rate. Early diagnosis as well as antibiotic therapy and the quality of debridement save the patients.

摘要

引言

本研究旨在描述和探讨福尼尔坏疽的流行病学、临床特征、治疗方法及病情演变。

材料与方法

采用病例系列研究,回顾性收集2010年1月至2017年3月间接受福尼尔坏疽治疗的患者资料。分析主要病因、危险因素、术后并发症及长期随访结果。

结果

共纳入84例患者。患者平均年龄49岁(范围20 - 76岁),男性占主导(83.33%),男女比例为5:1。最常见的危险因素是糖尿病(37%)。最常见的病因是肛周脓肿(32%)。平均就诊时间为8天(范围3 - 30天)。所有患者均在坏死期入院(100%)。85%的病例存在贫血。44.03%的病例出现血小板减少。93%的病例发现低蛋白血症。所有患者(100%)入院时均首先接受了复苏和抗生素治疗。他们接受了急诊手术清创并建立了清洁造口。平均住院时间为13天,33%的病例发生了并发症。死亡率为7.14%。

结论

福尼尔坏疽是一种内科 - 外科急症,发病率和死亡率高。早期诊断、抗生素治疗及清创质量对挽救患者生命至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e80/8577414/fd663b451482/gr1.jpg

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