高压氧联合多切口虚线引流治疗肛周坏死性筋膜炎患者的诊治体会  

Reflections on the diagnosis and treatment of perianal necrotizing fasciitis with combined hyperbaric oxygen and multiple incision with seton drainage procedure

作　　者：乔翠霞[1] 赵刚[1] 张立泽[1] 尤雯丽 逄承健 邸爱婷[1] 高海瑞[1] 万金娥[2] Qiao Cuixia;Zhao Gang;Zhang Lize;You Wenli;Pang Chengjian;Di Aiting;Gao Hairui;Wang Jin’e(Department of Anorectal Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Hyperbaric Oxygen,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院肛肠科,青岛266003 [2]青岛大学附属医院高压氧科,青岛266003

出　　处：《中华航海医学与高气压医学杂志》2025年第3期282-285,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的总结高压氧联合多切口虚线引流治疗肛周坏死性筋膜炎患者的诊治经验,以提高临床诊疗水平。方法回顾性分析青岛大学附属医院肛肠科收治的28例肛周坏死性筋膜炎患者,根据术后是否接受高压氧治疗,分为高压氧治疗组和对照组,对其一般资料及治疗方案进行总结。结果患者伴发疾病以糖尿病(14/28,50.00%)、低蛋白血症(21/28,75.00%)居多,感染累及会阴及阴囊25例(89.29%),致病菌以大肠埃希菌(11/28,39.28%)、肺炎克雷伯菌(8/28,28.57%)为主。与对照组相比,高压氧治疗组患者术后疼痛轻[疼痛评分为(1.93±0.71)分]、住院时间[(17.27±2.96)d]及创面完全愈合时间[(49.13±5.61)d]短,差异均有统计学意义(均P<0.05)。结论采用高压氧联合多切口虚线引流治疗肛周坏死性筋膜炎,疗效满意,值得临床推广应用。Objective To summarize the experience of diagnosing and treating perianal necrotizing fasciitis with combined hyperbaric oxygen and multiple incision with seton drainage procedure,so as to improve the capability of diagnosis and treatment.Methods A retrospective study was conducted on 28 patients with perianal necrotizing fasciitis treated at the Affiliated Hospital of Qingdao University.Based on whether they received hyperbaric oxygen therapy after operation,the patients were divided into a hyperbaric oxygen therapy group and a control group.General data and treatment protocols of both groups were summarized.Results The comorbidities most commonly observed in patients were diabetes(14/28,50.00%)and hypoproteinemia(21/28,75.00%),with infections affecting the perineum and scrotum in 25 cases(89.29%).The predominant pathogens were Escherichia coli(11/28,39.28%)and Klebsiella pneumoniae(8/28,28.57%).Compared with the control group,the patients in the hyperbaric oxygen therapy group experienced less postoperative pain[VAS score(1.93±0.71)points],shorter hospital stays[(17.27±2.96)days],and quicker complete wound healing[(49.13±5.61)days],with all differences being statistically significant(all P<0.05).Conclusion The efficacy of hyperbaric oxygen therapy combined with multiple incision with seton drainage procedure for the treatment of perianal necrotizing fasciitis is satisfactory and worthy of clinical promotion and application.

关 键 词：肛周坏死性筋膜炎 高压氧 多切口 虚线引流 

分 类 号：R657.1[医药卫生—外科学]