Objective To investigate the early diagnosis and effective treatment of Fournier syndrome. Methods The clinical data of 385 patients with perianal abscess in this hospital between 2006 and 2009 were retrospectively analyzed for screening the patients with complication of Fournier syndrome. Results Fournier syndrome was detected in 6 patients （1.56%）， who were all cured by treating with early incision and drainage, complete debridement, effective antibiotics, and supporting therapy. Conclusions Perianal abscess can induce Fournier syndrome of perineal, genital, and abdominal wall regions, which spreads rapidly and progressively, so early diagnosis and extensive surgical debridement play a decisive role on the prognosis.
目的总结坏死性筋膜炎的特点和治疗方法。 方法回顾性分析北京协和医院2000年2月至2014年3月期间所收治的20例坏死性筋膜炎病例的临床资料。 结果20例患者中男15例，女5例，男女比例3:1；发病年龄（52.3±11.0）岁（39～76岁）；病变部位双下肢11例，肛周7例，腹部切口1例，颈部1例。15例存在合并症，其中合并糖尿病7例。共18例患者接受手术，行1次手术者6例，2次及以上手术者12例，其中手术次数最多者达21次；另有1例患者因病重无手术机会而死亡，1例患者放弃抢救。共10例患者接受输血治疗。20例患者中好转13例（65%），转院2例（10%），死亡或放弃抢救治疗5例（25%）。 结论坏死性筋膜炎进展迅速，早期诊断较难，死亡率较高。彻底清创是最重要的治疗手段，多数患者需要多次手术来控制疾病的进展。
目的总结肛周坏死性筋膜炎（PNF）的临床特点、诊断及治疗方法。 方法回顾性分析我院肛肠外科2007年1月至2012年12月期间收治的22例PNF患者的临床资料。 结果全部病例均行手术治疗，术中彻底清创，术后给予抗炎、对症、支持治疗。痊愈18例，死亡4例。痊愈病例随访6个月未见复发。 结论PNF早期临床表现无特异性，诊断主要依据临床表现及相关影像学检查，治疗以手术为主，早期诊断，及时治疗，是治愈PNF、降低死亡率的关键。
ObjectiveTo analyze clinical features and treatment of cases of perineum necrotizing fasciitis with diabetes.MethodsThe 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.ResultsAmong 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).ConclusionsEarly 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.