真菌感染致四肢坏死性筋膜炎一例并文献复习
摘要
<正>坏死性筋膜炎(necro tizing fasciitis,NF)是一种非常罕见且高度致命的感染性疾病,常由多种细菌混合感染引起,以皮肤、皮下组织及深浅筋膜坏死为特征,发病后进展迅速,可在短时间内累计全身多个器官,如治疗不及时死亡率及致残率极高。NF一般发生于皮下软组织较为疏松的部位,如腹部、会阴部,而发生于四肢者不常见。本文以海南医学院第一附属医院收治的1例由真菌感染导致的四肢坏死性筋膜炎患者为报道内容,并复习国内外相关文献,对该病的诊断及治疗进行探讨。
引文
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[2] KAO LS, LEW DF, ARAB SN, et al. Local variations in the epidemiology, microbiology, and outcome of necrotizing soft tissue infections:a multi-center study[J]. American Journal of Surgery, 2011,202(2):139-145.
[3] KARKAS A, CHAHINE K, SCHMERBER S, et al. Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis[J]. Br J Surg, 2010, 97(4):609-615.
[4] ULUG M, GEDI KE, GI RGI NS, et al. The evaluation of microbiology and Fournier's gangrene severity index in 27 patients[J]. International Journal of Infectious Diseases, 2009, 13(6):e424-e430.
[5]韩志杰.坏死性筋膜炎诊治的研究进展[D].石家庄:河北医科大学, 2018.
[6] LANCEROTTO L, TOCCO I, SALMASO R, et al. Necrotizing fasciitis:classification, diagnosis, and management[J]. Journal of Trauma&Acute Care Surgery, 2012, 72(3):560-566.
[7] GOH T, GOH LG, ANG CH, et al. Early diagnosis of necrotizing fasciitis[J]. British Journal of Surgery, 2013, 101(1):e119-e125.
[8] YOUNG MH, ENGLEBERG NC, MULLA ZD, et al. Therapies for necrotising fasciitis[J]. Expert Opinion on Biological Therapy, 2006,6(2):155-65.
[9] WONG CH, CHANG HC, PASUPATHY S, et al. Necrotizing fasciitis:clinical presentation, microbiology, and determinants of mortality[J]. Journal of Bone&Joint Surgery American Volume, 2003, 85-A(8):1454.
[10] BILTON BD, ZIBARI GB, MCMILLAN RW, et al. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality:a retrospective study[J]. American Surgeon, 1998, 64(5):397-400.
[11] CHEN I, LI WC, HONG YC, et al. The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis[J]. Critical Care, 2011, 15(3):R152-R152.
[12]孙宝澍,邵为民,斯坎达尔,等.封闭式负压引流装置辅助治疗Fournier坏疽临床疗效观察[J].现代泌尿外科杂志, 2017, 22(10):40-42.
[13] CANOSO JJ, BARZA M. Soft tissue infections[J]. Rheumatic Diseases Clinics of North America, 1993, 19(2):293.
[14]罗理云,李烽辉,王颖菁,等.化脓性链球菌致脓毒症休克并右上肢坏死性筋膜炎1例报告[J].中国医药导刊, 2018, 20(5):285-288.
[15]罗妮娅,张力辉.坏死性筋膜炎合并糖尿病的研究进展[J].医学综述, 2017, 23(24):4921-4925.
[16] HAKKARAINEN TW, KOPARI NM, PHAM TN, et al. Necrotizing soft tissue infections:review and current concepts in treatment, systems of care, and outcomes[J]. Current Problems in Surgery, 2014,51(8):344-362.
[17] SINGH A, AHMED K, AYDIN A, et al. Fournier's gangrene. A clinical review[J]. Arch Ital Urol Androl, 2016, 88(3):157-164.
[2] KAO LS, LEW DF, ARAB SN, et al. Local variations in the epidemiology, microbiology, and outcome of necrotizing soft tissue infections:a multi-center study[J]. American Journal of Surgery, 2011,202(2):139-145.
[3] KARKAS A, CHAHINE K, SCHMERBER S, et al. Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis[J]. Br J Surg, 2010, 97(4):609-615.
[4] ULUG M, GEDI KE, GI RGI NS, et al. The evaluation of microbiology and Fournier's gangrene severity index in 27 patients[J]. International Journal of Infectious Diseases, 2009, 13(6):e424-e430.
[5]韩志杰.坏死性筋膜炎诊治的研究进展[D].石家庄:河北医科大学, 2018.
[6] LANCEROTTO L, TOCCO I, SALMASO R, et al. Necrotizing fasciitis:classification, diagnosis, and management[J]. Journal of Trauma&Acute Care Surgery, 2012, 72(3):560-566.
[7] GOH T, GOH LG, ANG CH, et al. Early diagnosis of necrotizing fasciitis[J]. British Journal of Surgery, 2013, 101(1):e119-e125.
[8] YOUNG MH, ENGLEBERG NC, MULLA ZD, et al. Therapies for necrotising fasciitis[J]. Expert Opinion on Biological Therapy, 2006,6(2):155-65.
[9] WONG CH, CHANG HC, PASUPATHY S, et al. Necrotizing fasciitis:clinical presentation, microbiology, and determinants of mortality[J]. Journal of Bone&Joint Surgery American Volume, 2003, 85-A(8):1454.
[10] BILTON BD, ZIBARI GB, MCMILLAN RW, et al. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality:a retrospective study[J]. American Surgeon, 1998, 64(5):397-400.
[11] CHEN I, LI WC, HONG YC, et al. The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis[J]. Critical Care, 2011, 15(3):R152-R152.
[12]孙宝澍,邵为民,斯坎达尔,等.封闭式负压引流装置辅助治疗Fournier坏疽临床疗效观察[J].现代泌尿外科杂志, 2017, 22(10):40-42.
[13] CANOSO JJ, BARZA M. Soft tissue infections[J]. Rheumatic Diseases Clinics of North America, 1993, 19(2):293.
[14]罗理云,李烽辉,王颖菁,等.化脓性链球菌致脓毒症休克并右上肢坏死性筋膜炎1例报告[J].中国医药导刊, 2018, 20(5):285-288.
[15]罗妮娅,张力辉.坏死性筋膜炎合并糖尿病的研究进展[J].医学综述, 2017, 23(24):4921-4925.
[16] HAKKARAINEN TW, KOPARI NM, PHAM TN, et al. Necrotizing soft tissue infections:review and current concepts in treatment, systems of care, and outcomes[J]. Current Problems in Surgery, 2014,51(8):344-362.
[17] SINGH A, AHMED K, AYDIN A, et al. Fournier's gangrene. A clinical review[J]. Arch Ital Urol Androl, 2016, 88(3):157-164.