肛周会阴部坏死性筋膜炎中西医治疗研究
Research on the Treatment of Perianal Perineal Necrotizing Fasciitis with Traditional Chinese and Western Medicine
DOI: 10.12677/acm.2024.1482274, PDF,    科研立项经费支持
作者: 云 昱*, 唐 枭, 吴宇琪, 康 健#:成都中医药大学临床医学院,四川 成都;成都中医药大学附属医院(四川省中医院)肛肠科,四川 成都
关键词: 肛周会阴部坏死性筋膜炎中西治疗综述Perianal Perineal Necrotizing Fasciitis Chinese and Western Treatments Review
摘要: 肛周会阴部坏死性筋膜炎是由细菌引起的急性坏死性感染疾病,在发病早期不易被诊断。通过相关检查可及时诊断该疾病。目前,肛周坏死性筋膜炎一经确诊,则需要进行手术治疗。针对炎症感染部位的不同选择不同的治疗方式,西医通过手术清创、引流等方式清除炎症感染灶,来促进疾病恢复。中医上通过内外合治来促进疾病愈合。中西医治疗可以对出现的疼痛、手术伤口等进行有效管理。文章通过介绍不同的中西医治疗方式,阐述当前肛周会阴部坏死性筋膜炎的治疗现状。
Abstract: Perianal perineal necrotizing fasciitis is an acute necrotizing infection caused by bacteria that is not easily diagnosed in the early stages of the disease. The disease can be diagnosed in a timely manner with relevant tests. Currently, once perianal necrotizing fasciitis is diagnosed, surgery is required. Different treatment methods are selected according to the different sites of inflammation and infection, and Western medicine removes the inflammation and infection foci through surgical debridement and drainage to promote the recovery of the disease. In traditional Chinese medicine, disease healing is promoted through internal and external treatment. TCM treatment can effectively manage the pain, surgical wounds, etc. This article introduces different treatment methods of traditional Chinese and Western medicine to illustrate the current treatment status of perianal perineal necrotizing fasciitis.
文章引用:云昱, 唐枭, 吴宇琪, 康健. 肛周会阴部坏死性筋膜炎中西医治疗研究[J]. 临床医学进展, 2024, 14(8): 729-735. https://doi.org/10.12677/acm.2024.1482274

参考文献

[1] Hagedorn, J.C. and Wessells, H. (2016) A Contemporary Update on Fournier’s Gangrene. Nature Reviews Urology, 14, 205-214. [Google Scholar] [CrossRef] [PubMed]
[2] Morais, H., Neves, J., Ribeiro, H.M., Ferreira, M., Guimarães, N., Azenha, N., et al. (2017) Case Series of Fournier’s Gangrene: Affected Body Surface Area—The Underestimated Prognostic Factor. Annals of Medicine & Surgery, 16, 19-22. [Google Scholar] [CrossRef] [PubMed]
[3] Singh, A., Ahmed, K., Aydin, A., Khan, M.S. and Dasgupta, P. (2016) Fournier’s Gangrene. A Clinical Review. Archivio Italiano di Urologia e Andrologia, 88, 157-164. [Google Scholar] [CrossRef] [PubMed]
[4] Wong, C., Chang, H., Pasupathy, S., Khin, L., Tan, J. and Low, C. (2003) Necrotizing Fasciitis. The Journal of Bone and Joint Surgery, 85, 1454-1460. [Google Scholar] [CrossRef
[5] Moussa, M. and Abou Chakra, M. (2019) Isolated Penile Fournier’s Gangrene: A Case Report and Literature Review. International Journal of Surgery Case Reports, 62, 65-68. [Google Scholar] [CrossRef] [PubMed]
[6] Pehlivanlı, F. and Aydin, O. (2019) Factors Affecting Mortality in Fournier Gangrene: A Single Center Experience. Surgical Infections, 20, 78-82. [Google Scholar] [CrossRef] [PubMed]
[7] Bersoff-Matcha, S.J., Chamberlain, C., Cao, C., Kortepeter, C. and Chong, W.H. (2019) Fournier Gangrene Associated with Sodium-Glucose Cotransporter-2 Inhibitors. Annals of Internal Medicine, 170, 764-769. [Google Scholar] [CrossRef] [PubMed]
[8] Scheen, A.J. (2019) An Update on the Safety of SGLT2 Inhibitors. Expert Opinion on Drug Safety, 18, 295-311. [Google Scholar] [CrossRef] [PubMed]
[9] Tang, L., Su, Y. and Lai, Y. (2015) The Evaluation of Microbiology and Prognosis of Fournier’s Gangrene in Past Five Years. SpringerPlus, 4, Article No. 14. [Google Scholar] [CrossRef] [PubMed]
[10] Zhang, N., Yu, X., Zhang, K. and Liu, T. (2020) A Retrospective Case Series of Fournier’s Gangrene: Necrotizing Fasciitis in Perineum and Perianal Region. BMC Surgery, 20, Article No. 259. [Google Scholar] [CrossRef] [PubMed]
[11] Ballard, D.H., Mazaheri, P., Raptis, C.A., Lubner, M.G., Menias, C.O., Pickhardt, P.J., et al. (2020) Fournier Gangrene in Men and Women: Appearance on CT, Ultrasound, and MRI and What the Surgeon Wants to Know. Canadian Association of Radiologists Journal, 71, 30-39. [Google Scholar] [CrossRef] [PubMed]
[12] 刘远成, 张劲远, 李永海, 等. 肛周坏死性筋膜炎患者4种血液生化指标对疾病预后的预测[J]. 医学研究生学报, 2020, 33(2): 164-168.
[13] 高丕尧, 廖存, 甘嘉亮, 等. 肛周坏死性筋膜炎辅助检查特点及不同手术治疗效果对比分析[J]. 重庆医学, 2017, 46(2): 225-227.
[14] Fernando, S.M., Tran, A., Cheng, W., Rochwerg, B., Kyeremanteng, K., Seely, A.J.E., et al. (2019) Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score. Annals of Surgery, 269, 58-65. [Google Scholar] [CrossRef] [PubMed]
[15] 朱倩, 朱桂松, 许飚. 坏死性筋膜炎的中西医治疗进展[J]. 内蒙古中医药, 2022, 41(3): 138-141.
[16] 何春梅, 曹永清, 郭修田, 等. 陆金根治疗肛周坏死性筋膜炎经验[J]. 中医杂志, 2005, 46(11): 817-818.
[17] 谭锦华, 郭魁, 石燕. 全程外科干预在肛周坏死性筋膜炎治疗中的应用体会——附1例病例报告[J]. 中国肛肠病杂志, 2021, 41(12): 28-30.
[18] 谢翔宇, 林正军, 林明慧. 肛周、会阴部急性坏死性筋膜炎诊疗体会[J]. 中国现代医药杂志, 2019, 21(4): 59-61.
[19] 宋顺心, 唐清珠, 罗宏标. 肛周坏死性筋膜炎外科清创与引流的疗效评价[J]. 中外医学研究, 2016, 14(9): 49-50.
[20] 张佳敏, 严建. 肛周合并下腹壁广泛性坏死性筋膜炎1例[J]. 现代医药卫生, 2022, 38(7): 1251-1253.
[21] 郭其乐, 姚向阳, 王琛. 肛周脓肿的术式选择及相应术后处理方法研究进展[J]. 中医临床研究, 2021, 13(33): 129-132+135.
[22] 赵小立, 宋美楠. 微小切口置管负压引流在乳腺脓肿手术中的应用效果及对并发症发生情况的影响[J]. 临床医学研究与实践, 2022, 7(18): 51-53.
[23] Zhou, E., Liu, S., Zhu, H., Yi, H. and Chen, X. (2020) Management and Postoperative Use of Double-Cannula Irrigation-Drainage Tube in Cervical Necrotizing Fasciitis: A Chinese Single-Institution Experience of 46 Patients. European Archives of Oto-Rhino-Laryngology, 278, 2975-2981. [Google Scholar] [CrossRef] [PubMed]
[24] 曾云谦, 甘辛, 康皓. 负压封闭引流联合人工皮技术在创面修复中应用的研究进展[J]. 骨科, 2024, 15(2): 187-192.
[25] 何爱娟, 叶信海. 自体皮肤移植的临床研究进展[J]. 中国眼耳鼻喉科杂志, 2023, 23(2): 123-127.
[26] Shimada, K., Ojima, Y., Ida, Y., Komiya, T. and Matsumura, H. (2021) Negative-Pressure Wound Therapy for DonorSite Closure in Radial Forearm Free Flap: A Systematic Review and Meta-Analysis. International Wound Journal, 19, 316-325. [Google Scholar] [CrossRef] [PubMed]
[27] 丛进春, 陈春生, 张宏, 等. 超低位直肠癌行臀大肌替代部分括约肌重建肛门[J]. 中国肿瘤临床, 2007, 34(14): 807-810.
[28] 李少杰, 冯昱, 胡安安, 等. 新型敷料在慢性创面愈合中的作用及研究进展[J]. 中国医疗美容, 2022, 12(12): 49-54.
[29] 吴燕虹, 张黎明, 王玉芝, 等. 封闭式负压引流联合抗菌敷料对人工真皮移植术后糖尿病足溃疡创面愈合的影响[J]. 中国临床研究, 2022, 35(12): 1662-1666.
[30] 高东岩, 张帆. 外科围手术期镇痛的体会[J]. 医学信息, 2014(15): 376.
[31] 贾旗, 汪明. 肛肠病术后外用药物镇痛的研究进展[J]. 中国肛肠病杂志, 2022, 42(12): 68-70.
[32] 鲁丹, 史季, 孙洪霞. 肛周坏死性筋膜炎的临床诊治体会[J]. 中国卫生标准管理, 2016, 7(22): 33-34.
[33] 胡捷, 钟霞, 董勇云. 肛周坏死性筋膜炎误诊三例报告[J]. 临床误诊误治, 2018, 31(2): 15-19.
[34] 郭玮妮, 陆文洪. 中医外治法治疗肛周坏死性筋膜炎术后研究进展[J]. 江西中医药, 2024, 55(1): 74-77.
[35] 袁以洋, 王景祥, 梁勋, 于庆生. 中药联合VSD治疗大面积坏死性筋膜炎2例[J]. 中医药临床杂志, 2016, 28(12): 1770-1771.
[36] 薄灵芳, 陈贵婧, 冯江雪. 坏死性筋膜炎的辩证分析[J]. 临床医药文献电子杂志, 2020, 7(31): 69-70.
[37] Zhu, L., Ma, S., Jia, C., Zhang, B., Ma, Z. and Park, E. (2020) Chinese Herbal Fumigant and Lotion for Postoperative Complication in Surgical Wound of Anal Fistula. Medicine, 99, e22095. [Google Scholar] [CrossRef] [PubMed]
[38] Rat, A., Naranjo, H.D., Krigas, N., Grigoriadou, K., Maloupa, E., Alonso, A.V., et al. (2021) Endophytic Bacteria from the Roots of the Medicinal Plant Alkanna tinctoria Tausch (Boraginaceae): Exploration of Plant Growth Promoting Properties and Potential Role in the Production of Plant Secondary Metabolites. Frontiers in Microbiology, 12, Article 633488. [Google Scholar] [CrossRef] [PubMed]
[39] 王辉, 曲建辉. 肛周坏死性筋膜炎术后复方黄柏液创面灌洗促进创面愈合临床观察[J]. 实用中医药杂志, 2018, 34(7): 844-845.
[40] 王乐炜, 赵凤芹, 韩丽, 王建民. 双氧水和复方黄柏液交替冲洗促进肛周坏死性筋膜炎术后创面愈合作用观察[J]. 中医药临床杂志, 2018, 30(6): 1154-1157.
[41] 李花玉, 武庆花. 清解消炎汤冲洗联合负压封闭引流术治疗肛周坏死性筋膜炎的临床观察[J]. 中国中医急症, 2021, 30(10): 1776-1778.