封闭式负压引流技术辅助治疗阴茎、阴囊坏疽4例临床分析  

Vacuum sealing drainage as an adjuvant treatment of penile and scrotal gangrene:Clinical analysis of 4 cases

作　　者：朱通[1] 廖良功 李彦锋[1] 刘旭东[1] 胡明[1] 张勇[1] 李中泰[1] 曹全富[1] 江军[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所泌尿外科,重庆400042

出　　处：《中华男科学杂志》2017年第3期237-242,共6页National Journal of Andrology

摘　　要：目的:通过分析总结封闭式负压引流技术辅助治疗阴茎、阴囊坏疽的临床疗效,探讨该类疾病的最佳治疗方法。方法:收集整理2015年1月至2016年6月,收治的4例阴茎、阴囊坏疽患者的临床诊治资料,回顾分析其治疗过程中配合使用封闭式负压引流技术的方法及其疗效。4例患者均早期行广泛、彻底的阴囊、阴茎坏疽清创术,并静脉应用二联广谱抗生素,清创后为充分创面引流,应用封闭式负压引流(VSD),待创面清洁后,予以创面缝合。结果:4例患者经配合使用封闭式负压引流技术后,坏疽创面引流更加充分,阴囊、阴茎坏疽范围快速局限化,未出现睾丸坏死情况。4例患者均在坏疽创面清洁后,二期缝合,创面顺利愈合后出院。3个月后随访,局部创面愈合良好,无复发。结论:应用封闭式负压引流冲洗技术配合早期行广泛、彻底清创可有效促进坏疽范围的局限化,显著降低换药频率和缩短患者住院周期,是治疗阴茎阴囊坏疽的极为有效的辅助治疗手段。Objective ： To search for an optimal strategy for the treatment of penile and scrotal gangrene by analyzing the clinical effect of vacuum sealing drainage （VSD） as an adjuvant treatment on this disease. Methods ： We retrospectively analyzed the clinical data about 4 cases of penile and serotal gangrene treated by VSD as an adjuvant treatment from January 2015 to June 2016. The 4 pa- tients all underwent early extensive and radical debridement of gangrene of the scrotum and penis and received intravenous injection of two broad-spectrum antibiotics, followed by VSD for wound drainage and irrigation. Results ： Adequate wound drainage was achieved in all the 4 cases, the gangrene range rapidly localized and testicular necrosis avoided. The wound surface healed satisfactorily after cleansing and suturing. The patients were followed up for 3 months after discharged from the hospital and none experienced recurrence. Conclusion： VSD combined with early adequate debridement can effectively localize the gangrene range, significantly reduce the fre- quency of changing dressings and shorten the hospitalization time of the patient, and therefore is a very effective adjuvant treatment of penile and scrotal gangrene.

关 键 词：阴茎 阴囊坏疽 FOURNIER坏疽 封闭式负压引流 

分 类 号：R699.8[医药卫生—泌尿科学]