CAJ | 학술논문

目的总结坏死性筋膜炎(necrotizing fasciitis,NF)的临床诊断和治疗经验. 方法回顾性分析中国医科大学附属第一医院2006-2012年24例坏死性筋膜炎的临床资料,并总结诊治体会.结果本组24例坏死性筋膜炎患者,其中男19例,女5例；年龄25 ～ 72岁,平均年龄(54±12)岁.发病部位:会阴部、臀部16例,左下肢3例,背部2例,右下肢2例,右下肢及左背部l例.治疗方法:24例均采取广泛切开引流、彻底清创及有效的抗生素治疗,其中输白蛋白13例,输血9例,应用肠外营养19例,接受高压氧治疗15例.24例中一期治愈17例(70.83％),二期植皮4例(16.67％),复发2例(8.33％),死亡1例(4.17％).结论坏死性筋膜炎起病较急,进展迅速,必须尽早确诊,给予有效抗生素治疗的同时强调早期切开引流、彻底清创,并要加强临床护理及相关营养等支持疗法.
목적 총결배사성근막염(necrotizing fasciitis,NF)적림상진단화치료경험. 방법 회고성분석중국의과대학부속제일의원2006-2012년24례배사성근막염적림상자료,병총결진치체회.결과 본조24례배사성근막염환자,기중남19례,녀5례；년령25 ～ 72세,평균년령(54±12)세.발병부위:회음부、둔부16례,좌하지3례,배부2례,우하지2례,우하지급좌배부l례.치료방법:24례균채취엄범절개인류、철저청창급유효적항생소치료,기중수백단백13례,수혈9례,응용장외영양19례,접수고압양치료15례.24례중일기치유17례(70.83％),이기식피4례(16.67％),복발2례(8.33％),사망1례(4.17％).결론 배사성근막염기병교급,진전신속,필수진조학진,급여유효항생소치료적동시강조조기절개인류、철저청창,병요가강림상호리급상관영양등지지요법.
Objective To study the clinical diagnosis and treatment ot necrotizing fasciitis.Methods We retrospectively analyzed the clinical data of 24 necrotizing fasciitis cases between 2006 and 2012.Results There were 24 necrotizing fasciitis patients,including 19 men and 5 women,aging from 25 to 72 years (mean =54.3 years).Main pathological process started in perineum and buttock in 16 patients,in left lower extremity in 3 patients,in back in 2 patients,in right lower extremity in 2 patients,and in right lower extremity and back in one.Extensive incision and drainage was achieved in 24 patients combined with debridement and effective antibiotic therapy.Albumin was given in 13 patients,9 patients received blood transfusion,19 patients received parenteral nutrition support and 15 patients received hyperbaric oxygen treatment.17 patients (70.83％) were cured primary stage,4 patients (16.67％) received skin graft,2 patients (8.33％) relapsed and 1 patient(4.17％) died.Conclusions Necrotizing fasciitis which is acute and progressing rapidly needs to be diagnosed and treated at an early stage.We emphasize on drainage and debridement thoroughly,and we use antibiotics combined with clinical care and nutrition support therapy.