FENG Li , WANG Min , DU Zhicheng , LI Xin , QIAO Yi
  • Department of General Surgery, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, P. R. China;
WANG Min, Email: 361642215@qq.com
perineum necrotizing fasciitis; diabetes mellitus; Klebsiella pneumoniae
10.7507/1007-9424.201810070
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Objective To analyze clinical features and treatment of cases of perineum necrotizing fasciitis with diabetes.Methods The clinical data of 48 cases of perineum necrotizing fasciitis with diabetes were retrospectively collected in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from 2013 to 2017. The clinical features, bacterial culture results, and laboratory indicators such as the white blood cell count (WBC), platelet (PLT), C reactive protein (CRP), serum sodium (Na+), potassium (K+), calcium (Ca2+), and blood sugar (Glu) levels were compared between the diabetic patients and the non-diabetic patients and between the death and the survival.Results Among the 48 cases, there were 29 cases of perineum necrotizing fasciitis with diabetes, 10 cases of death, 36 cases of positive results of bacterial culture. ① Between the diabetic patients and the non-diabetic patients, the proportions of the gender, surgery within 24 h, staying the ICU, and death had no significant differences (P>0.05); the age, time from onset to admission, and staying time in the ICU had no significant differences too (P>0.05). The Klebsiella infection rate in the diabetic patients was significantly higher than that in the non-diabetic patients (P<0.05). There were no significant differences in the CRP, WBC, PLT, Ca2+, Na+, and K+ levels between the diabetic patients and the non-diabetic patients on the 1st, the 3rd, and the 7th day of the admission (P>0.05). ② The proportions of the gender and surgery within 24 h had no significant differences (P>0.05), but of staying the ICU had a significant difference (P<0.05) between the death and the survival; the age, the time from onset to admission, and staying time in the ICU had no significant differences (P>0.05). The positive rate of bacterial culture results had no significant difference between the death and the survival (P>0.05). Except for the PLT (P<0.05), there were no significant differences in the CRP, WBC, and Glu levels between the death and the survival on the 1st and 3rd day of the admission (P>0.05).Conclusions Early diagnosis, early operation, and multidisciplinary treatment are important in treatment of perineum necrotizing fasciitis. Antibiotics which are sensitive to Klebsiella when treated with early experimental use should be considered for patients with diabetes mellitus.

Citation： FENG Li, WANG Min, DU Zhicheng, LI Xin, QIAO Yi. Clinical characteristics and treatment of perineum necrotizing fasciitis with diabetes mellitus (Report of 48 cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(1): 72-76. doi: 10.7507/1007-9424.201810070 Copy

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