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福尼尔坏疽的治疗：造口是必需的吗？

Fournier Gangrene Management: Is a Stoma Mandatory?

作者信息

Dupont Margarida, Leal Clara, Tenreiro Nadia, Marques Rita, Pinto-de-Sousa João

机构信息

General Surgery, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PRT.

General Surgery, Centro Hospitalar de Trás-Os-Montes e Alto Douro, Vila Real, PRT.

出版信息

Cureus. 2023 May 24;15(5):e39450. doi: 10.7759/cureus.39450. eCollection 2023 May.

DOI:10.7759/cureus.39450
PMID:37378202
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10292068/
Abstract

Fournier gangrene is a rare life-threatening surgical emergency mainly due to a polymicrobial infection of the perineal, genital, or perianal region. It is characterized by rapid tissue destruction and systemic signs of toxicity. It is more frequent in males and immunocompromised patients, such as patients with poorly controlled diabetes, alcoholism, or human immunodeficiency virus (HIV) infection. Treatment often involves surgical intervention, broad-spectrum antibiotic therapy, fecal diversion surgery, and negative pressure wound therapy (NPWT). Delays in diagnosis are associated with high mortality due to rapid progression to septic shock.

摘要

福尼尔坏疽是一种罕见的危及生命的外科急症，主要由会阴、生殖器或肛周区域的多种微生物感染引起。其特征是组织迅速破坏和全身中毒症状。在男性以及免疫功能低下的患者中更为常见，如糖尿病控制不佳、酗酒或感染人类免疫缺陷病毒（HIV）的患者。治疗通常包括手术干预、广谱抗生素治疗、粪便转流手术和负压伤口治疗（NPWT）。由于迅速进展为感染性休克，诊断延迟与高死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7214/10292068/556afe061b6f/cureus-0015-00000039450-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7214/10292068/4a77bf87bcb9/cureus-0015-00000039450-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7214/10292068/556afe061b6f/cureus-0015-00000039450-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7214/10292068/4a77bf87bcb9/cureus-0015-00000039450-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7214/10292068/556afe061b6f/cureus-0015-00000039450-i02.jpg

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Fournier Gangrene Management: Is a Stoma Mandatory?福尼尔坏疽的治疗：造口是必需的吗？
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Fournier gangrene: role of imaging.福尼尔坏疽：影像学的作用
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本文引用的文献

1
Fournier Gangrene in the Emergency Department: Diagnostic Dilemmas, Treatments and Current Perspectives.急诊科的福尼尔坏疽：诊断困境、治疗方法及当前观点
Open Access Emerg Med. 2020 Nov 9;12:353-364. doi: 10.2147/OAEM.S238699. eCollection 2020.
2
Fournier Gangrene in Men and Women: Appearance on CT, Ultrasound, and MRI and What the Surgeon Wants to Know.男性和女性 Fournier 坏疽：CT、超声和 MRI 的表现，以及外科医生想了解的情况。
Can Assoc Radiol J. 2020 Feb;71(1):30-39. doi: 10.1177/0846537119888396. Epub 2020 Jan 28.
3
Suture Technique to Prevent Air Leakage during Negative-Pressure Wound Therapy in Fournier Gangrene.
用于预防Fournier坏疽负压伤口治疗期间空气泄漏的缝合技术
Plast Reconstr Surg Glob Open. 2018 Jan 25;6(1):e1650. doi: 10.1097/GOX.0000000000001650. eCollection 2018 Jan.
4
Using negative pressure therapy for improving skin graft taking on genital area defects following Fournier gangrene.使用负压疗法改善福尼尔坏疽后生殖器区域缺损的皮肤移植成活率。
Turk J Urol. 2017 Sep;43(3):366-370. doi: 10.5152/tud.2017.92845. Epub 2017 Aug 1.
5
Comparison of Diverting Colostomy and Bowel Management Catheter Applications in Fournier Gangrene Cases Requiring Fecal Diversion.需要粪便转流的Fournier坏疽病例中结肠造口术与肠道管理导管应用的比较
Indian J Surg. 2015 Dec;77(Suppl 2):438-41. doi: 10.1007/s12262-013-0868-6. Epub 2013 Jan 27.
6
Enterostomy can decrease the mortality of patients with Fournier gangrene.肠造口术可降低福尼尔坏疽患者的死亡率。
World J Gastroenterol. 2014 Jun 28;20(24):7950-4. doi: 10.3748/wjg.v20.i24.7950.