Giuly E, Velly L, Gouin F
Département d'anesthésie-réanimation adultes, CHU de La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
Ann Fr Anesth Reanim. 2006 Sep;25(9):978-81. doi: 10.1016/j.annfar.2006.03.020. Epub 2006 May 3.
Necrotizing soft tissue infections represent a group of rapidly progressive diseases requiring early and repeated debridement, associated with broad spectrum antibiotics. Delay in surgery or inadequate therapy are the main risk factors for death. Most patients need aggressive critical care management and intensive nutritional support. The management of these patients by experimented senior surgeons is mandatory. A plastic surgeon can help debridement in order to preserve possibilities of later myocutaneous or rotational skin flaps. Intravenous immunoglobulins are an efficacious adjunctive therapy for severe group A streptococcal infection.
坏死性软组织感染是一组进展迅速的疾病，需要早期反复清创，并联合使用广谱抗生素。手术延迟或治疗不充分是死亡的主要危险因素。大多数患者需要积极的重症监护管理和强化营养支持。由经验丰富的资深外科医生对这些患者进行管理是必不可少的。整形外科医生可以协助清创，以保留后期进行肌皮瓣或旋转皮瓣手术的可能性。静脉注射免疫球蛋白是治疗严重A组链球菌感染的一种有效辅助疗法。
