FOURNiER GANGRENi: HASTANEDE YATIM SORESiNi ...

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unsurlardlr (15). Biz KBY/Oremiyi hastanede kahm sOresini uzatan tek
e~zamanh durum olarak belirledik. Oremik hastalarda T lenfosit, monosit ve
n6trofil fonksiyonlan bozuktur ve B lenfosit antikor yamtlan yetersizdir(16).
Hastalanmlzdan diabetik aym zamanda KBY'li ve paraplejik 2 olguyu
kaybettik.Bu hastalar agn yakmmalan olmadlklan i9in septik ~ok geli~ene
kadar klinik ba~vuruda bulunmaml~lardl.Lezyon niteligi a91smdan gangrenin
penis ve skrotum gibi panduler organlardan kaynaklanmasl durumunda ;
kavernozal dokulann ve testisin kendilerini 6rten cilt ve cilt altl dokularmdan
farkh arteriyel kaynaklannm olmasl nedeniyle pandOler organ ba~langl9h
olgularda hastanede kahm sOrelerinin daha klsa olabilecegi savlanabilir.Ancak
hastalanmlzda lezyonun ba~langl9 yerinin yatl~ sOresini etkilemedigini
saptadlk. Penis ve skrotum ba~langl9h olgularda ; Colles fasyasmm anatomik
uzamm planlan nedeniyle, bu olgular perine,anus ve gluteus gibi g6vde
Ozerinde ba~layan olgulara oranla hastahgm yaYlhml konusunda ayncahkh
klhnmaz. Klinik ve hekim kadrosu olarak hatm saYlhr deneyimimiz,
sefalosporin, aminoglikozit ve anaerob etkili antibiotikten olu~an tlbbi
tedavimiz,hemodinamik stabilizasyon 6zenimiz, bazl durumlarda gOnde 2 ve
daha fazla debridman karan verebilecek tarzda devingen hasta izlemimiz %
6.8 gibi dO~Okmortalite oranmm a91klamasl olabilir. Sonu9 olarak 29 olguluk
. deneyimimizle, Fournier gangrenli hastalarda KBYIOremi hastanede yatma
sOresinietkileyen tek bireysel degi~ken olarak belirlendi.
SUMMARY
FOURNIER'S GANGRENE: FACTORS PREDICT LONG
HOSPITAL STAY
The records of 29 patients with Fournier's gangrene treated in University
of Dicle, Medical School, Department of Urology, between 1988 and 1999 were
reviewed. Attempts were made to identify causative or predisposing factors and
models of presentation. Patient age and length of hospital stay were recorded.
The patients were divided into two groups and compared; patients with
hospitalization longer or shorter than 30 days. End staged renal disease/uremia
was identified as a unique individual variable affects hospital stal.
Kel Words: Uremia, Fournier's Gargrene, Haspitalization.
KAYNAKLAR
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3. Pizzorno R, Bonnini F, Repetto U. Hyperbaric oxygen therapy in early phase
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4. A~91 R, Sankaya S, BOyOkalpelli R, Yllmaz A F, Ylldlz S. Fournier's
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collagenase application. Eur Uro11998: 34; 411-418