ГАНГРЕНА ФУРНЬЕ - РАЗНОВИДНОСТЬ КЛИНИЧЕСКОЙ МОДЕЛИ КРИТИЧЕСКИХ СОСТОЯНИЙ В ХИРУРГИИ

Аннотация

The investigation based on a retrospective analysis of the treatment results of Fournier’s gangrene (FG) in 27 patients aged from 34 till 82 years old. There were 27 patients. Diseases of colorectal zone were the nosological reasons of FG in 15 patients. Diseases of urogenital tract had 10 patients with FG. The development of FG was determined by closed trauma (1 patient) and a gunshot wound of the perineum and the scrotum in one patient. The slowly progressive (limited) forms of the disease were noted in 15 patients, although the rapid progressive (extensive) forms were in 12 patients. All the patients had the clinical manifestations of the disease and at the same time laboratory indices indicated a presence of generalized infection and they were characterized by symptoms of systemic inflammatory response syndrome (SIRS). There were 6 patient, who died out of 27.The lethality consisted of 22,2%. The reasons of the death were an infection- toxic shock (1 case), a progressive endotoxicosis (3 cases) and a pulmonary artery thromboembolism (2 cases). The results obtained testified that early diagnostics and the active strategy with radical surgical d-bridement of necrotic suppurative foci combined with programmed (staged) sanitation necrosectomy, complex system of local wound treatment, the rational antibacterial therapy, a task-specific and syndrome correction of dyscrasia could be the actual ways to improve the treatment results in patients with FG.