阴囊脓肿24例临床特征与疗效研究

Clinical features and treatment outcome of scrotal abscess: an analysis of 24 cases

摘要:

目的 探讨并分析阴囊脓肿患者的临床特点，为临床诊疗提供依据。方法 借助电子病案系统对重庆医科大学附属第二医院2016年1月至2021年9月收治的阴囊脓肿患者的临床资料进行回顾性分析总结。结果 共纳入24例阴囊脓肿患者，平均年龄（49.29±17.05）岁。主要症状包括阴囊胀痛、红肿、破溃流脓甚至全身发热症状。合并疾病以附睾炎为主（7例，29%）。16例患者行脓液培养，其中11例为阳性（69%），致病菌主要为大肠埃希氏菌、葡萄球菌及厌氧菌等。患者用抗生素保守治疗者4例（17%）；行脓肿切开引流+抗生素治疗者20例（83%），其中4例进行了病灶探查切除，3例术后病理活检示结核性肉芽肿性炎，予调整为抗结核药物治疗（13%）。24例患者病情均明显好转出院，平均住院时间为（12.96±7.53） d。1例患者痊愈出院3年后复发。结论 阴囊脓肿一旦确诊应尽早行切开引流并给予强有力的抗感染治疗。对患者加强健康卫生观念教育有助于预防此类疾病发生。

Abstract:

Objective To investigate the clinical features of patients with scrotal abscess，and to provide a basis for clinical diagnosis and treatment of the disease.Methods We retrospectively analyzed the clinical data of patients with scrotal abscess collected from the electronic medical record system of The Second Affiliated Hospital of Chongqing Medical University from January 2016 to September 2021.Results A total of 24 patients with scrotal abscess were included，with a mean age of （49.29±17.05） years. The clinical symptoms included scrotal pain，redness，swelling，and purulent ulceration and even systemic fever. Epididymitis was the main comorbid condition（7 cases，29%）. Among the 16 patients having a pus culture test，11（69%） were positive for pathogenic bacteria，which were mainly Escherichia coli，Staphylococcus，and anaerobic bacteria. Four（17%） cases were treated conservatively with antibiotics alone； and 20（83%） cases were treated with abscess incision and drainage combined with antibiotic therapy，of whom four patients underwent lesion resection and pathological examination，resulting in a treatment change to anti-tuberculosis drugs in three（13%） cases due to the findings of tuberculous granulomatous inflammation. All the 24 patients had significantly remissions on discharge，with a mean length of hospital stay of （12.96±7.53） days. One patient relapsed three years after discharge with cure.Conclusion Scrotal abscess should be treated with incision and drainage and potent anti-infective treatment as soon as possible once confirmed. Education on health and personal hygiene should be administered to prevent its occurrence.