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坏疽性脓皮病的外科治疗:病例报告及文献复习

Surgical management of pyoderma gangrenosum: case report and review.

作者信息

Alam M, Grossman M E, Schneiderman P I, Blume R S, Benvenisty A I

机构信息

Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.

出版信息

Dermatol Surg. 2000 Nov;26(11):1063-6. doi: 10.1046/j.1524-4725.2000.0260111063.x.

Abstract

BACKGROUND

Commonly used treatments for pyoderma gangrenosum are medical, with immunosuppressive agents employed most often.

OBJECTIVE

To report a case and discuss the indications for radical surgical treatment of pyoderma gangrenosum.

METHODS

Analysis of a case of Crohn's disease-associated pyoderma gangrenosum treated with immunosuppression followed by amputation, and a review of the literature on surgical management of pyoderma gangrenosum.

RESULTS

In unstable patients with intractable multiple medical problems, surgical treatment of pyoderma gangrenosum may be indicated by the existence of these life-threatening comorbidities. The recent literature suggests that surgical management of pyoderma gangrenosum may also be appropriate in other special circumstances.

CONCLUSIONS

Surgical management, including amputation, may have a role in the management of pyoderma gangrenosum. Further research is needed to delineate precisely the circumstances and patient factors that are appropriate indications for such surgery.

摘要

背景

坏疽性脓皮病常用的治疗方法是药物治疗,最常使用免疫抑制剂。

目的

报告一例病例并讨论坏疽性脓皮病根治性手术治疗的指征。

方法

分析一例克罗恩病相关的坏疽性脓皮病患者,先采用免疫抑制治疗,后行截肢手术,并回顾坏疽性脓皮病手术治疗的相关文献。

结果

对于患有顽固性多种内科问题且病情不稳定的患者,坏疽性脓皮病的手术治疗可能因存在这些危及生命的合并症而有必要。近期文献表明,在其他特殊情况下,坏疽性脓皮病的手术治疗也可能是合适的。

结论

包括截肢在内的手术治疗可能在坏疽性脓皮病的治疗中发挥作用。需要进一步研究以精确界定适合此类手术的情况和患者因素。

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