Nhân một trường hợp hoại thư fournier nặng: Từ cắt lọc cấp cứu đến tạo hình vạt da che khuyết da lớn=A case report: Severe fournier gangrene from emergency debridement to large skin flap reconstruction

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Vương Kiệt Đoàn, Trương Tuấn Đạt Lê, Văn Ân Nguyễn, Huy Vũ Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.3-9

Bộ sưu tập: Metadata

ID: 242678

Thêm vào giỏ

Trình bày một trường hợp hoại thư Fournier nặng được điều trị tại Bệnh viện Đại học Y Dược TP. HCM Đối tượng và phương pháp: Đây là báo cáo trường hợp lâm sàng. Người bệnh sưng đau nhiều vùng bìu 2 bên, sốt, nhập viện tuyến trước được chẩn đoán hoại thư Fournier, được rạch dẫn lưu và đặt meche vùng bìu 2 bên, tình trạng không cải thiện nên nhập cấp cứu Bệnh viện Đại học Y Dược TP. HCM. Chụp cộng hưởng từ vùng bụng chậu ghi nhận áp xe hóa lan rộng vùng bìu – tầng sinh môn, lan lên thành bụng phải. Người bệnh được phẫu thuật cấp cứu cắt lọc toàn bộ mô hoại tử kết hợp chăm sóc vết thương tích cực. Sau đó người bệnh được phẫu thuật tái tạo lại vùng vết thương hở. Kết quả: Sau 3 tháng từ thời điểm cấp cứu, người bệnh đã hoàn toàn bình phục và quay lại cuộc sống bình thường. Bàn luận và kết luận: Điều trị toàn diện một trường hợp hoại thư Fournier sẽ bắt đầu từ phẫu thuật cấp cứu với cắt lọc toàn bộ mô hoại tử (kết hợp hồi sức tích cực và kháng sinh phổ rộng) đến tối ưu hóa việc chăm sóc vết thương, giúp vết thương hồi phục nhanh và cuối cùng là phẫu thuật tái tạo da che vùng vết thương hở.We report a case of severe Fournier gangrene, which was treated at the University of Medical Center of HCMC (UMC). Patient and method: This is the case study: A male patient came to the local hospital due to scrotum pain and fever. He were diagnosed with Fournier gangrene. Then were drained and placed meche in the scrotum on both sides, the condition did not improve, so they were admitted to the UMC. Magnetic resonance imaging of the pelvic abdomen recorded that the abscess spread to the scrotum – episiotomy, spreading to the right abdominal wall. Patient were treated with emergency debridement combined with active wound care. The patient then undergoes reconstructive surgery on the open wound area. Result: After 3 months from the time of the emergency, the patient has completely recovered and returned to normal life. Discussion & conclusion: Comprehensive treatment of a Fournier gangrene will start from emergency debridement (combining aggressive resuscitation and broad-spectrum antibiotics) to optimize wound care, help wounds heal quickly and finally, skin flap reconstruction to cover the open wound area.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR