- 期刊
Surgical experience in Fournier's gangrene
佛耳尼埃氏壞疽的外科經驗
摘要
佛耳尼埃氏壞疽係會陰部一種迅速蔓延的壞死性筋膜炎，此病常併發於肛門、直腸或泌尿道的感染，但有一部分仍無明顯的原因。此病的典型是會陰部猛然的發炎，且迅速擴展至波及陰莖，腹壁及大腿內側。由於蔓延迅速，並常造成全身性敗血症，因此死亡率相當高。其治療包括迅速而廣泛的清創，適當的抗生素，併發疾病的治療，及陰囊和會陰部外觀的重建。 本文係整理臺大醫院自1986年至1993年之8個病例，全部均為男性，年齡從24歲到62歲，平均為40歲，4個病例為糖尿病患者。其致病原因，其中3個是肛門，直腸的膿瘍,l個是泌尿道感染，1個是下腹部燒傷。 培養的菌種均呈現嗜氧及厭氧的混合性感染，其中以腸內桿菌最多，鏈球菌居次。在陰囊及會陰的重建，當缺損不大時則直接縫合，在缺損較大而不宜直接縫合時，則以股薄肌皮辨來重建。本文並列舉三個案例及以圖片說明我們對陰囊及會陰的重建方法。
關鍵字
無資料並列摘要
Fournier's gangrene is a fulminant, rapidly spreading synergistic infection involving the scrotum and perineum. The disease may occur without an apparent precipitating cause and follow a variety of clinical conditions. It is associated with severe systemic toxicity and significant mortality rate, and it demands prompt recognition and urgent, aggressive surgical intervention. Eight cases treated at National Taiwan University Hospital from July 1986 to May 1993 were reviewed. All cases were evaluated according to age, sex, bacteriology, etiology and the outcome. There were no mortality. In addition, scrotal reconstruction using three different methods were displayed.