Puymirat E, Garnier S, Parizano J-F, Grand H, Guimard C-R, Gauche B
Service de réanimation, CHU Robert-Boulin, avenue de la Marne, 33505 Libourne, France.
Ann Fr Anesth Reanim. 2007 Jan;26(1):81-4. doi: 10.1016/j.annfar.2006.08.012. Epub 2006 Nov 13.
We are reporting the case of a 39-year-old male, without notable previous history except for an important alcoholic and tobacco consumption, who suffered a bicycle accident resulting in a minor wound on the left elbow. The neglected wound evolved extremely rapidly towards a necrotizing fasciitis, which underwent further complications consisting of a heat shock and multivisceral failure that necessitated reanimation procedures. The patient benefited a triple antibiotic therapy (amoxicillin-clavulanic acid, ornidazole and levofloxacin) and an extensive surgical debridement. The progression was then slow but favourable. The patient is now in functional reeducation. This observation illustrates the rate of evolution of the lesions caused by necrotizing fasciitis and reminds on the importance of prompt therapy.
我们报告了一名39岁男性的病例，该患者既往无明显病史，仅有大量饮酒和吸烟史，他遭遇了一场自行车事故，导致左肘部有一处轻伤。被忽视的伤口迅速发展为坏死性筋膜炎，并出现了进一步的并发症，包括热休克和多脏器功能衰竭，需要进行复苏治疗。患者接受了三联抗生素治疗（阿莫西林-克拉维酸、奥硝唑和左氧氟沙星）以及广泛的手术清创。随后病情进展缓慢但情况良好。患者目前正在进行功能康复训练。该病例说明了坏死性筋膜炎所致病变的发展速度，并提醒人们及时治疗的重要性。
