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我们在一家三级护理中心对 Fournier 坏疽的经验及其与血液计数参数的关系分析。

Our experience on Fournier's gangrene in a tertiary-stage care center and analysis of its relationship with blood count parameters.

机构信息

Department of Urology, Gülhane Training and Research Hospital, Ankara-Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2022 Sep;28(9):1285-1291. doi: 10.14744/tjtes.2021.50245.

Abstract

BACKGROUND

Fournier's gangrene (FG) is rapidly progressing and life-threatening necrotizing fasciitis of genital and perineal regions. The aim of the study was to share our experience with FG and to analyze the relationship of clinical data with whole blood count parameters, inflammation cells, and systemic inflammation markers.

METHODS

The digital medical records of the adult patients followed-up and treated with diagnosis of FG between January 2016 to December 2020 were retrospectively analyzed. Data were as age, gender, total length of hospital stay, predisposing factors, etiological factors, total number of debridement's, surgical procedures, and antibiotherapy were collected. Serum glucose levels, complete blood count parameter levels, serum inflammation indicators and C-reactive protein (CRP) levels measured at the initial day of hospital admission, post-debridement 1st and 7th days were measured.

RESULTS

Thirty-six male patients were included, with a mean age of 56.42 (22-86) years. The most common predisposing factor was diabetes mellitus (n=13; 36.1%). The most frequently seen etiological cause was scrotal abscess (n=19; 52.8%). A statistically significant decrease was found in White blood cell count, neutrophil level, neutrophil-to-lymphocyte ratio (NLR) value and CRP level measured before debridement, post-debridement 1st and 7th days (p<0.05). There was a positive correlation between the number of debridement's and age, NLR, platelet-to-lymphocyte ratio, and CRP values at the initial admission time (p<0.05).

CONCLUSION

The infections of urogenital region are the essential etiological origin of FG. As a rare urological emergency, significant changes were observed in clinical data and blood count parameters during the course of FG.

摘要

背景

Fournier 坏疽(FG)是一种迅速发展且危及生命的生殖器和会阴区域坏死性筋膜炎。本研究旨在分享我们在 FG 方面的经验,并分析临床数据与全血细胞计数参数、炎症细胞和全身炎症标志物之间的关系。

方法

回顾性分析了 2016 年 1 月至 2020 年 12 月期间被诊断为 FG 的成年患者的数字医疗记录。收集的数据包括年龄、性别、总住院时间、易患因素、病因、清创术总数、手术程序和抗生素治疗。测量入院当天、清创后第 1 天和第 7 天的血清葡萄糖水平、全血细胞计数参数水平、血清炎症指标和 C 反应蛋白(CRP)水平。

结果

共纳入 36 例男性患者,平均年龄为 56.42(22-86)岁。最常见的易患因素是糖尿病(n=13;36.1%)。最常见的病因是阴囊脓肿(n=19;52.8%)。清创前、清创后第 1 天和第 7 天测量的白细胞计数、中性粒细胞水平、中性粒细胞与淋巴细胞比值(NLR)值和 CRP 水平均显著下降(p<0.05)。入院时 NLR、血小板与淋巴细胞比值、CRP 值与清创次数呈正相关(p<0.05)。

结论

泌尿生殖区感染是 FG 的主要病因。作为一种罕见的泌尿科急症,FG 病程中观察到临床数据和血细胞计数参数的显著变化。

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