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中国临床研究:2025,38(1):118-121
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多切口对口引流联合坏死筋膜切除治疗重症胸腹壁坏死性筋膜炎
(1. 西安航天总医院普通外科,陕西 西安 710100;2. 西安交通大学第一附属医院普通外科,陕西 西安 710061;3. 空军军医大学唐都医院普通外科,陕西 西安 710038)
Multiple incision contradrainage and necrotic fascia resection in the treatment of severe necrotizing fasciitis of thoracic and abdominal wall
摘要
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投稿时间:2023-12-30   网络发布日期:2025-01-20
中文摘要: 目的 总结多切口对口引流联合坏死筋膜切除治疗重症胸腹壁坏死性筋膜炎的临床治疗经验。 方法 回顾性分析2019年11月至2021年3月西安航天总医院收治的3例胸腹壁坏死性筋膜炎患者的临床资料,均采取多切口对口引流+坏死筋膜切除,其中1例联合阴囊睾丸切除,分析患者预后、实验室检查及细菌培养结果等。 结果 3例患者中男性2例,女性1例,所有患者C反应蛋白均高于150 mg/L,降钙素原均高于5 ng/mL,白细胞升高均不明显,甚至降低。均经手术、抗感染及综合治疗,3例患者住院时间分别为36、7、48 d。1例患者放弃治疗死亡;另外2例患者治愈出院,随访生活质量良好。 结论 早期诊断、及早手术、手术方式的合理选择、规范抗感染治疗以及生命支持等综合治疗方可有效提高坏死性筋膜炎患者的存活率,获得较好的预后和生活质量。
Abstract:Objective To summarize the clinical experience of multiple incision contradrainage and necrotic fascia resection in the treatment of severe necrotizing fasciitis of thoracic and abdominal wall. Methods The clinical data of 3 patients with necrotizing fasciitis of thoracic and abdominal wall admitted to Xi'an Aerospace General Hospital from November 2019 to March 2021 were retrospectively analyzed. All 3 patients received multiple incisions contradrainage and necrotic fascia resection, with 1 patient combined with scrotal and testicular resection. The prognosis, laboratory tests and bacterial culture results of patients were analyzed. Results There were 2 males and 1 female. In 3 patients, C-reactive protein was higher than 150 mg/L, procalcitonin was higher than 5ng /mL, and white blood cells were not significantly elevated and even decreased. All patients were treated with surgery, anti-infection and comprehensive treatment. The hospitalization time of the three patients was 36, 7 and 48 days respectively. One patient gave up treatment and died. The other 2 patients obtained a better prognosis and quality of life. Conclusion Early diagnosis, early operation, reasonable selection of surgical methods, standard anti-infective therapy and life support can effectively improve the survival rate, better prognosis and life quality of patients with necrotizing fasciitis.
文章编号:     中图分类号:R63    文献标志码:A
基金项目:陕西省自然科学基础研究计划项目(2022JM-604)
附件
引用文本:
周正赟,张鹏军,成建璋,等.多切口对口引流联合坏死筋膜切除治疗重症胸腹壁坏死性筋膜炎[J].中国临床研究,2025,38(1):118-121.

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