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腹腔镜左半结肠切除术治疗憩室炎后发生的坏死性筋膜炎。

Necrotizing fasciitis following laparoscopic left hemicolectomy for diverticulitis.

作者信息

Brodik Golo, van Bilsen Sef J A, Becker Thomas, Jasker Petra, Otte Wolf-Dieter

机构信息

Department of General and Visceral Surgery, Marienhospital Wesel, Wesel, Germany.

出版信息

J Laparoendosc Adv Surg Tech A. 2010 Feb;20(1):65-7. doi: 10.1089/lap.2009.0318.

Abstract

Necrotizing fasciitis (NF) is a rapidly progressing bacterial infection of soft skin tissue layers, combined with high mortality rates. Association with laparoscopic surgery is rare. In this article, we report a case of a 61-year-old patient suffering from severe NF after laparoscopic left hemicolectomy with low anterior resection due to diverticulitis of sigmoid colon. Skin discolorations, combined with critical illness of the patient, led to the diagnosis of NF. Early recognition, intensive care treatment with stabilization of vital parameters, broad-band antibiotics, and aggressive debridement are the cornerstones for successful treatment of NF.

摘要

坏死性筋膜炎(NF)是一种进展迅速的皮肤软组织层细菌感染,死亡率很高。与腹腔镜手术相关的情况很少见。在本文中,我们报告了一例61岁的患者,该患者因乙状结肠憩室炎接受腹腔镜左半结肠切除术加低位前切除术后发生严重坏死性筋膜炎。皮肤变色,再加上患者的危急病情,导致了坏死性筋膜炎的诊断。早期识别、通过稳定生命体征进行重症监护治疗、使用广谱抗生素以及积极清创是成功治疗坏死性筋膜炎的基石。

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