Hefny Ashraf F, Eid Hani O, Al-Hussona Mudher, Idris Kamal M, Abu-Zidan Fikri M
Department of Surgery, Al-Ain Hospital, UAE University, Al-Ain, United Arab Emirates.
Eur J Emerg Med. 2007 Feb;14(1):50-2. doi: 10.1097/01.mej.0000228447.48276.7b.
The objective of the study was to evaluate our recent experience in diagnosis and management of necrotizing fasciitis. Records of patients who were diagnosed as having necrotizing fasciitis at Al-Ain Hospital in the period between March 2003 and August 2005 were studied retrospectively with regard to clinical features, risk factors, diagnosis, causative organisms, treatment, and outcome. Eleven patients, eight of whom were men of low socio-economic status, were studied. The median age (range) was 46 (8-65) years. The main risk factor was diabetes mellitus in seven patients (64%). The provisional clinical diagnosis was incorrect in seven patients (64%). Pure beta-hemolytic streptococcus group A or B was the causative organism in five patients (46%). Most of our patients underwent multiple surgical debridements with a median range of two (1-11) operations. Two patients died (overall mortality rate 18%). High clinical suspicion is essential for the diagnosis of necrotizing fasciitis. Accurate early diagnosis, aggressive resuscitation, using proper antibiotics, and extensive surgical debridement are essential for a favorable outcome.
本研究的目的是评估我们近期在坏死性筋膜炎诊断和治疗方面的经验。回顾性研究了2003年3月至2005年8月期间在艾因医院被诊断为坏死性筋膜炎的患者记录，内容包括临床特征、危险因素、诊断、致病微生物、治疗及预后。共研究了11例患者，其中8例为社会经济地位较低的男性。中位年龄（范围）为46（8 - 65）岁。主要危险因素是7例患者（64%）患有糖尿病。7例患者（64%）的初步临床诊断有误。5例患者（46%）的致病微生物为纯A组或B组β溶血性链球菌。我们的大多数患者接受了多次手术清创，手术次数中位数范围为2次（1 - 11次）。2例患者死亡（总死亡率18%）。高度的临床怀疑对坏死性筋膜炎的诊断至关重要。准确的早期诊断、积极的复苏、使用合适的抗生素以及广泛的手术清创对于取得良好预后至关重要。
