Fournier坏疽的解剖学基础及其临床意义

目的探讨Fournier坏疽的解剖学特征,为临床诊治提供指导。方法收集1997年1月至2011年6月收治的Fournier坏疽患者21例临床资料,结合文献进行分析讨论。结果 1例（1/21,4.76%）因并发脓毒血症导致多器官脏器衰竭死亡。糖尿病为最常见合并症（3/21,14.29%）。Fournier坏疽患者病变沿各部浅筋膜深层范围进行延伸（17/21,80.95%）,少有侵透深筋膜（1/21,4.76%）。Fournier坏疽常见致病菌为链球菌、大肠杆菌、金黄色葡萄球菌、拟杆菌、梭状芽孢杆菌等,其中6例（6/21,28.57%）患者脓液中培养出2种以上细菌。结论掌握Fournier综合征的病理生理及解剖学特性,有助于对患者的病情和预后做出及时准确的诊断和治疗。

Anatomic basis of Fournier gangrene and its clinical significance

Objective To analyze the anatomic characteristics of Fournier gangrene and to provide references in clinics.Methods The clinical data of 21 patients with Fournier gangrene from January 1997 to June 2011 were reviewed and discussed combined with literature analysis.Results One（1/21,4.76%） patient was died due to multiple organ failure induced by septicopyemia.Coexisting diabetes mellitus was found in three patients（3/21,14.29%）.The infection of Fournier gangrene was extended along the superficial fascia in 17 patients（17/21,80.95%） with 1 patient（1/21,4.76 %） experiencing deep fascia infection.The most commonly found bacteria were streptococcal species,escherichia coli,staphylococcus,bacteroides,clostridium,et al.More than two organisms were cultured in 6 patients（6/21,28.57%）.Conclusion Familiarity with the anatomic and path physiological characteristics of Fournier gangrene is important in the diagnosis and treatment of Fournier gangrene.