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相關文獻
- Management of Fournier's Gangrene--Experience with 57 Patients
- Prognostic Factors and Strategy of Treatment in Fournier's Gangrene: A 12-Year Retrospective Study
- 福耳尼埃氏壞疽--會陰生殖器的壞死性筋膜炎
- 福耳尼埃氏壞疽: 會陰及生殖器壞死性筋膜炎文獻回顧
- Hyperbaric Oxygen Therapy in Extensive Fournier's Gangrene--Our Experience of Treatment
- 一位福耳尼埃氏壞疽患者之照護經驗
- 壞死性筋膜炎
- Prompt Recognition of Necrotizing Fasciitis in a Newborn
- Necrotizing Fasciitis Caused by Perforated Hollow Viscus--Case Report
- 壞死性筋膜炎
頁籤選單縮合
題 名 | Management of Fournier's Gangrene--Experience with 57 Patients=福耳尼埃氏壞疽--57位病人的治療經驗 |
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作 者 | 劉冠麟; 陳志碩; 馮思中; 朱聖賢; | 書刊名 | 中華民國泌尿科醫學會雜誌 |
卷 期 | 9:3 1998.09[民87.09] |
頁 次 | 頁121-125 |
分類號 | 416.27 |
關鍵詞 | 福耳尼埃氏壞疽; 壞死性筋膜炎; 會陰感染; Fournier's gangrene; Necrotizing fasciitis; Perineal infection; |
語 文 | 英文(English) |
中文摘要 | 福耳尼埃氏壞疸是會陰及生殖部位筋膜快速進行的壞死性感染(壞死性筋膜炎),並 且常合併覆蓋其上皮膚的壞疸。自民國74年1月至民國86年8月,共有57位福耳尼埃氏 壞疸病患於林口長庚醫院接受治療。這些病患的年齡由28歲至82歲(平均55歲)。其中28 位病患有糖尿病;10位病患有肝硬化。57位病患中,25位感染部侷限在會陰、陰囊、陰莖 和睪丸;另外32位病患則蔓延至腹股溝、腹部、腰部或大腿。進行細菌培養的38位病患中, 有36位培養出多種菌種,只有2位是單一菌種。33位病患源自肛門直腸的感染,5位病患 源自泌尿生殖道的感染。病患均接受廣泛性的清創手術,廣效性的抗生素治療,及經常的傷 口換樂處理。23位病患接受結腸造口手術,6位病患接受恥骨上膀胱造廔手術。有12位病 患須進行重建手術。共有26位病患發生敗血性休克,並造成14位病患死亡。經研究結果發 現:蔓延的福耳尼埃氏壞疸比侷限性的福耳尼埃氏壞疸有較高的死亡率,敗血症是造成病患 死亡最重要的因素,因此我們的治療策略便是在防止福耳尼埃氏壞疸的蔓延,以及控制敗血 症的進展;而源自肛門直腸感染之福耳尼埃氏壞疸可能比源自泌尿生殖道感染之福耳尼埃氏 壞疸有較高的死亡率,對於源自肛門直腸感染之福耳尼埃氏壞疸,早期的結腸造口手術可能 降低其死亡率。 |
英文摘要 | Fournier's gangrene is a rapidly progressive necrotizing infection of the perineal and genital fascia (necrotizing fasciitis). This paper analyzes the factors related to the mortality of patients with Fournier's gangrene and clarifies the treatment strategy of Fournier's gangrene with different origins. From Jan. 1985 to Aug. 1997, 57 patients with Fournier's gangrene were treated at the Chang Gung Memorial Hospital in Taoyuan. Their medical records were reviewed and analyzed. The patients' ages ranged from 28 to 82 yr (mean 55). Twenty-eight patients had diabetes mellitus and 10 had liver cirrhosis; 25 patients had lesions limited to the perineum and scrotum; however, 32 patients had lesions which had spread to the inguinal area, abdomen, or thigh. Fournier's gangrene of anorectal origin was observed in 33 patients and of urogenital origin in 5 patients. An average of 2.47 debridements per patient were performed. Colostomy was performedk in 23 patients and suprapubic cystostomy in 6 patients. Septic shock was observed in 26 patients and all of the 14 expired patients died of sepsis. In conclusion, the mortality rate of Fournier's gangrene with extensive lesions might be higher than that with localized lesions. Bacteremia and sepsis are the major indicators of mortality rate for Fournier's gangrene. Fournier's gangrene of anorectal origin might have a higher mortality rate than that of urogenital origin. Diverting colostomy performed at the onset might be beneficial in cases of infection arising from anorectal origin. |
本系統中英文摘要資訊取自各篇刊載內容。