中国热带医学
中國熱帶醫學
중국열대의학
CHINA TROPICAL MEDICINE
2005年
4期
696-699
,共4页
周学鲁%谭学君%叶伟洪%黄坚%莫琰%卢广明%张继峰%李成忠%胡灏%苏永全%周惠成
週學魯%譚學君%葉偉洪%黃堅%莫琰%盧廣明%張繼峰%李成忠%鬍灝%囌永全%週惠成
주학로%담학군%협위홍%황견%막염%로엄명%장계봉%리성충%호호%소영전%주혜성
溃疡分支杆菌%皮肤感染%Buruli溃疡%中国
潰瘍分支桿菌%皮膚感染%Buruli潰瘍%中國
궤양분지간균%피부감염%Buruli궤양%중국
Mycobacterium ulceran infection%Buruli ulcer%China
目的描述Buruli溃疡的病理、病原体的形态特征以及治疗特点,以提高对本病的认识. 方法复习有关文献,根据临床和病理分析6例下肢及上肢慢性溃疡病人,按照WHO诊断标准作出临床诊断,并皆经病理和PCR检测证实.溃疡采用切除加植皮术治疗. 结果 5例单发溃疡中左下肢4例,右下肢1例.1例为多发溃疡,病变位于左右下肢及左食指.溃疡直径2.5～6.5cm,平均3.2cm.其特点是皮肤及皮下组织坏死,边缘呈潜行性,底部有黄色坏死物覆盖.溃疡周围皮肤水肿和色素沉着.显微镜下见到细胞外有散在或成团的抗酸杆菌和坏死脂肪细胞-"鬼影细胞".抗结核药物和抗生素对本组Buruli溃疡无较,5例行手术切除溃疡加植皮术或清创术,除1例复发外,4例治疗效果良好.另1例行清创术换药后溃疡愈合. 结论 Buruli溃疡可以在我国的亚热带地区发生,因此当遇到久经不愈的慢性皮肤溃疡时,要考虑患有Buruli溃疡的可能性.外科手术仍然是目前治疗Buruli溃疡的主要方法.
目的描述Buruli潰瘍的病理、病原體的形態特徵以及治療特點,以提高對本病的認識. 方法複習有關文獻,根據臨床和病理分析6例下肢及上肢慢性潰瘍病人,按照WHO診斷標準作齣臨床診斷,併皆經病理和PCR檢測證實.潰瘍採用切除加植皮術治療. 結果 5例單髮潰瘍中左下肢4例,右下肢1例.1例為多髮潰瘍,病變位于左右下肢及左食指.潰瘍直徑2.5～6.5cm,平均3.2cm.其特點是皮膚及皮下組織壞死,邊緣呈潛行性,底部有黃色壞死物覆蓋.潰瘍週圍皮膚水腫和色素沉著.顯微鏡下見到細胞外有散在或成糰的抗痠桿菌和壞死脂肪細胞-"鬼影細胞".抗結覈藥物和抗生素對本組Buruli潰瘍無較,5例行手術切除潰瘍加植皮術或清創術,除1例複髮外,4例治療效果良好.另1例行清創術換藥後潰瘍愈閤. 結論 Buruli潰瘍可以在我國的亞熱帶地區髮生,因此噹遇到久經不愈的慢性皮膚潰瘍時,要攷慮患有Buruli潰瘍的可能性.外科手術仍然是目前治療Buruli潰瘍的主要方法.
목적묘술Buruli궤양적병리、병원체적형태특정이급치료특점,이제고대본병적인식. 방법복습유관문헌,근거림상화병리분석6례하지급상지만성궤양병인,안조WHO진단표준작출림상진단,병개경병리화PCR검측증실.궤양채용절제가식피술치료. 결과 5례단발궤양중좌하지4례,우하지1례.1례위다발궤양,병변위우좌우하지급좌식지.궤양직경2.5～6.5cm,평균3.2cm.기특점시피부급피하조직배사,변연정잠행성,저부유황색배사물복개.궤양주위피부수종화색소침착.현미경하견도세포외유산재혹성단적항산간균화배사지방세포-"귀영세포".항결핵약물화항생소대본조Buruli궤양무교,5례행수술절제궤양가식피술혹청창술,제1례복발외,4례치료효과량호.령1례행청창술환약후궤양유합. 결론 Buruli궤양가이재아국적아열대지구발생,인차당우도구경불유적만성피부궤양시,요고필환유Buruli궤양적가능성.외과수술잉연시목전치료Buruli궤양적주요방법.
Objective To report the six Mycobacterium ulcerans infections (Buruli ulcer) in China which is the third most common mycobacterial infection in West Africa after tuberculosis and leprosy. with literterature review and to provide sciertific information for diagnosis and treal ment of the disease. Methods Six patients with chronic ulcers in lower or upper extremities were diagnosed clinically, and confirmed either by histopathologically, or by PCR or both, then managed by surgical approach of the six caoes.Results One case was male, one male and five were females, with an averaged age of 69 years (47 ～ 83 years). The clinical manifestations of the patients were deep, indolent, chronic ulcer with undermined margin in their legs in five cases, and in the legs and left finger in one case. Left side outnumbered right one. The diameter of the ulcer was 2.5 ～ 6.5 cm, averaged 3.2 cm. The microscopic findings in the lesion showed extra-cellular anti-fast bacilli and ghost cells. Anti-tuberculosis drugs and antibiotics have no effectiveness to the patients. Six cases had a satisfactory result except one whe had recurrent ulcer after surgical intervention. Conclusion Chronic unusual skin lesions. occurred in this country should consider Mycobacterium ulcerans infection Surgery remains the mainstay of potentially curative treatment.
