肛周坏死性筋膜炎不良预后的危险因素分析OA

Objective To explore the risk factors for poor prognosis in patients with Fournier's gangrene(FG),and to provide reference for clinical prognosis assessment and treatment optimization.Methods The clinical data of 127 FG patients admitted to Nanjing Hospital of Chinese Medicine from January 2021 to Novem-ber 2024 were retrospectively analyzed.According to the prognosis,they were divided into the poor prognosis group(43 cases)and the routine group(84 cases).Demographic characteristics,underlying diseases,labora-tory indicators and infected sites(a total of 9 anatomical regions)were collected,and the Fournier's Gangrene Severity Index(FGSI)and Uludag FGSI scores were calculated.Independent sample t-test,χ² test or Fisher's exact test were used to compare the differences between groups,and univariate Logistic regression analysis was used to screen the factors related to poor prognosis.Results The prevalence of diabetes,the rate of deep fas-cia involvement and the rate of lower extremity/inguinal region involvement in the poor prognosis group were significantly higher than those in the routine group(P<0.05 or P<0.001).The Uludag FGSI score of patients in the poor prognosis group was significantly higher than that in the routine group(P<0.001).There was no significant difference in the traditional FGSI score between the two groups(P>0.05).Univariate ber of infected regions(P<0.001)were key risk factors for poor prognosis;while involvement of lower extremities(P<0.001)and other specific regions showed a protective association.Conclusion The poor prognosis of FG patients is closely related to diabetes,infection range and Uludag FGSI score.Due to the inclu-sion of infection region division factors,Uludag FGSI score has better efficacy in prognosis assessment.Deep fascia involvement is a strong predictor of poor prognosis of FG;the protective association presented by the involvement of lower extremities and inguinal regions may be affected by sample bias and should be interpreted with caution.This study is a single-center retrospective study,and the results need to be further verified by multi-center prospective studies.