特发性阴囊坏疽合并附睾炎1例

阴囊坏疽由法国的皮肤病学家Fournier于1883年首先描述，故又称Fournier综合征或Fournier坏疽。马永江于1956年最早在国内报告此病。它是一种可危及生命的发生在男性外生殖器及会阴部的爆发性快速进展的坏死性筋膜炎，死亡率可达35%。我科2014年5月收治1例特发性阴囊坏疽合并附睾炎患者，现报告如下。     

Fournier坏疽7例报告

阴囊坏疽是一种协同感染的阴茎、阴囊及会阴坏死性炎症，是一种极严重、罕见的感染性疾病，起病急，发展迅速，死亡率高。若诊断不及时，处理不当，会危及患生命。自1995年1月-2003年8月共收治特发性阴囊坏疽(Fourmer坏疽)7例，报告如下。     

Fournier坏疽1例报告

Fournier坏疽是一种临床上少见的阴茎、阴囊及会阴甚至肛门周围组织的感染性坏死性筋膜炎。病情凶险，发展迅速，如不能及时诊断治疗，死亡率较高。现报告我院收治1例如下：     

Fournier坏疽1例报告

Ｆｏｕｒｎｉｅｒ坏疽１例报告第一医院皮肤科何晓琴，张发听中图分类号Ｒ７５３；Ｒ６３４Ｆｏｕｒｎｉｅｒ坏疽是坏死性筋膜炎的一种特殊类型，好发于男性阴囊。阴茎及会阴，临床上极罕见。现报告一例并结合文献就有关问题进行讨论。患者男性，５６岁。因阴囊、阴茎肿胀...     

阴囊坏疽8例报告

阴囊坏疽是坏死性筋膜炎的一型，是较为少见的急性感染性疾病。它具有发病急，进展迅猛，病死率高的特点。近几年来，我院共收治了8例此病患者，现报告如下。     

特发性阴囊坏疽6例诊治体会

特发性阴囊坏疽属于坏疽性筋膜炎的特殊类型,是一种暴发性发作的阴囊、阴茎、会阴及腹壁组织迅速发生严重坏疽的少见疾病,其起病急,发展迅速,病死率高,若诊断不及时,处理不当,会危及患者生命。1998年以来,我院共收治6例,现分析报告如下。     

特发性阴囊坏疽7例报告

目的探讨特发性阴囊坏疽的治疗方法。方法回顾分析7例特发性阴囊坏疽治疗方案。结果7例患者均行外科清创、引流、抗感染、湿敷等治疗。患者术后恢复迅速。结论早期诊断，及时彻底多次的清创，引流冲洗，敏感抗生素的使用，创面湿敷是治疗成功的关键。     

特发性阴囊坏疽4例诊治报告

特发性阴囊坏疽是一种少见、凶险的外科疾病。1883年Fournier首先描述，故称为Fournier’s坏疽。另也称阴囊坏疽性丹毒、产气坏疽、链球菌性阴囊坏疽等。1983年以来，我院共收治4例，现分析报告如下。     

特发性阴囊坏疽（附4例报告）

特发性阴囊坏疽（附４例报告）青海省人民医院泌尿外科刘智明特发性阴囊坏疽是一种罕见、凶险的外科疾病。１８８３年Ｆｏｕｒｎｉｅｒ首先描述，故也称Ｆｏｕｒｎｉｅｒ’ｓ坏疽。另也称阴囊坏疽性丹毒、产气坏疽、链球菌性阴囊坏疽等。１９８３年以来，共经治４例，现报...     

阴囊阴茎坏疽7例治疗分析

阴囊阴茎坏疽是一种少见的坏死性筋膜炎,呈暴发性发作及迅速进展的阴囊、阴茎皮下组织感染.我院1992～2000年共收冶阴囊阴茎坏疽7例,经治疗后均获得满意效果,现报道如下.     

糖尿病并发急性坏死性筋膜炎五例诊治分析

目的探讨急性坏死性筋膜炎的病因病理、临床特点和治疗原则。方法报告5例糖尿病并发急性坏死性筋膜炎患者的诊治经过并进行相关文献复习。结果5例糖尿病并发急性坏死性筋膜炎患者经抗休克、清创、浅部挂橡皮筋引流、深部置管引流冲洗、抗炎、控制血糖及对症支持等治疗,均治愈出院。结论急性坏死性筋膜炎是一种累及肛周、阴囊和会阴部的感染性坏死性筋膜炎,及时正确的诊断、处理可减少其死亡率和并发症;CT检查有利于确定此病的累及范围和发现一些隐蔽病灶;治疗原则为早期清创,正确引流,全身应用大剂量广谱抗生素及治疗基础疾病。     

Necrotizing fasciitis

Necrotizing fasciitis is a devestating condition which has been recognized for several years. In North America a recent increase of cases has led to much media attention and public fear. Necrotizing fasciitis may occur as a consequence of infection with Streptococcus pyogenes or as a result of a polymicrobial synergistic infection caused by aerobic, anaerobic, gram positive and gram negative organisms, often in postoperative patients. Necrotizing fasciitis caused by Streptococcus pyogenes is mediated by superantigens. The management of necrotizing fasciitis requires a high index of suspicion for diagnosis followed by antimicrobial therapy and early surgical intervention. In cases caused by Streptococcus pyogenes with streptococcal toxic shock syndrome, intravenous immunoglobulin may be of benefit.     

肛周坏死性筋膜炎13例的临床分析

目的探讨肛周坏死性筋膜炎的诊断及治疗方法。方法对中国医科大学附属第一医院肛肠外科自2008年9月-2011年8月间收治的13例肛周坏死性筋膜炎患者全部行肛周清创引流术。术中充分引流清创,并抽取脓汁作细菌培养和药敏试验。术后给抗炎、对症、支持治疗。结果本组13例患者全部治愈。平均手术时间为130 min。术后常规应用美罗培南7～10 d,并监测血常规。术后第3天WBC降至(10.5～11.7)×109/L,中性粒细胞百分率降至79%～84%;术后第7天WBC降至(8.7～10.3)×109/L,中性粒细胞百分率降至63%～71%。体温降至36.7～37.2℃。患者住院天数为15～24 d,平均住院日为21 d,平均住院费用15 605.41元。所有患者随访1年,未发现复发。结论早期诊断并给予彻底的清创引流是治疗的关键,及时有效的抗炎、对症、支持治疗可以改善患者的预后。     

Necrotizing fasciitis of the male genitalia (Fournier''s gangrene).

Necrotizing fasciitis of the male genitalia was first described 100 years ago. Although the mortality of this condition has generally been high, the last few years have seen dramatic therapeutic improvements. This paper details the treatment of necrotizing fasciitis in two patients and describes a plan of management, which includes early diagnosis, vigorous antibiotic treatment and radical débridement of the necrotic tissues, that should improve the prognosis of the condition.     

坏死性筋膜炎的诊断与治疗(附16例分析)

目的:探讨坏死性筋膜炎的早期诊断与治疗方法。方法:对16例坏死性筋膜炎患者采用早期彻底清创、全身营养支持、抗感染、创面延期修复。结果:该类患者大多数有外伤史,并具有典型的局部表现和明显的脓毒症症状。16例患者均治愈。结论:对坏死性筋膜炎进行早期诊断、彻底清创、全身营养支持、合理用药、创面延期修复,能取得较好的治疗效果。     

老年肛痈术后合并坏死性筋膜炎治疗体会

目的:探讨老年肛痈术后合并坏死性筋膜炎的病因病理、临床特点和中西医结合治疗的优势。方法:10例老年肛痈术后合并坏死性筋膜炎患者给予抗感染、原发内口挂线、口服中药汤剂、控制血糖、中药换药及对症支持等中西医结合治疗。结果:1例好转,9例患者痊愈出院,创面愈合时间为25~50天,平均35天。肛门局部无功能障碍。坏死性筋膜炎病变区瘢痕少,无功能障碍。结论:中西医结合可以有效治疗肛痈术后合并坏死性筋膜炎的老年患者;可以避免病变组织缺损,减少瘢痕形成,并保全患者病变组织器官的功能。     

Cervical necrotizing fasciitis due to klebsiella

Necrotizing fasciitis is an aggressive infection involving fascia and subcutaneous tissue thus causing infectious thrombosis of the nutrient vessels to the overlying skin ultimately leading to extensive necrosis. Although necrotizing fasciitis is common in the perineum, abdominal wall and extremities it is relatively uncommon in the head and neck region. This is a case report of a 65 year old female visiting from India who presented with diabetic ketoacidosis precipitated by cervical necrotizing fasciitis. Computed tomography imaging showed involvement of the left parapharyngeal space and there was soft tissue gas present. This patient subsequently underwent an emergency neck exploration and desloughing. Repeated pus culture studies isolated Klebsiella species as the sole pathogen. Our case illustrates that prompt diagnosis and treatment of cervical necrotizing fasciitis can ensure a good outcome.     

Necrotizing fasciitis: an alternative approach

Three cases of necrotizing fasciitis are presented. The initial management of necrotizing fasciitis remains undisputed. However, following a limited success with a conventional treatment policy, a more radical approach with immediate skin grafting following debridement is suggested.     

Necrotizing fasciitis following varicella in a child

Varicella is a self-limited disease, but sometimes it may be associated with some serious life-threatening complications. Necrotizing fasciitis is a rare complication of varicella. This is a case of a 7-year-old girl with septic shock caused by necrotizing fasciitis as a complication of varicella. Swelling and pain in the left inguinal region and left axillary region were found five days after varicella. Then a high fever occurred followed by hypotension. Fluid infusion, vasopressor and antibiotics were administered. Group A beta-hemolytic Streptococcus was isolated from exudates from the wounds. The clinical symptoms markedly improved after surgical drainage and removal of the necrotic tissue. Both wounds were covered with skin grafts after healthy granulation tissue formed. Although there have been few reports of life-threatening necrotizing fasciitis following varicella in western countries, it is rare in China. Usually patients with varicella were admitted to pediatric or infectious disease department but not surgical departments; so that the clinicians should be aware that varicella may be complicated by life-threatening surgical infections. Necrotizing fasciitis should be suspected in patients of varicella who showed an increasing pain and swelling in any body areas associated with increasing fever and local erythema. Early identification, surgical drainage and debridement are essential for successful treatment of necrotizing fasciitis.

     

颈部坏死性筋膜炎6例

目的:提高临床医师对颈部坏死性筋膜炎的认识。方法:回顾分析6例颈部坏死性筋膜炎患者的临床资料及治疗结果。结果:6例患者经手术及药物治疗,5例治愈,1例因并发脓毒血症导致多器官功能衰竭死亡。结论:颈部坏死性筋膜炎是一种进展迅速、病情凶险的感染性疾病,治疗上以尽早彻底清创、应用广谱抗菌素及支持治疗为主,增加对该病的认识有利于早期诊断,并有利于提高颈部坏死性筋膜炎的疗效。