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颈部坏死性筋膜炎:我们对11例病例的经验及手术清创技术。

Cervical necrotizing fasciitis: Our experience with 11 cases and our technique for surgical debridement.

作者信息

Bakshi Jaimanti, Virk Ramandeep S, Jain Ajay, Verma Mayuresh

机构信息

Department of Otolaryngology-Head and Neck Surgery, PGIMER, Chandigarh, India.

出版信息

Ear Nose Throat J. 2010 Feb;89(2):84-6.

Abstract

We conducted a retrospective review of 11 cases of adult cervical necrotizing fasciitis that were treated at our institution over a period of 5-plus years. The most common etiology was a dental infection, which was seen in 7 of the 11 patients (64%). Most cultures were sterile because all of these patients had been referred to us after they had already been treated elsewhere with intravenous antibiotics and without surgical intervention. Under our management, patients spent an average of 21.6 days in the hospital, and they underwent an average of 1.6 debridements under general anesthesia. Aggressive wound care, broad-spectrum antibiotic therapy, and timely surgical intervention resulted in an overall survival rate of 91% (10/11), including a 75% survival (3/4) for patients with thoracic extension.

摘要

我们对本机构在5年多时间里治疗的11例成人颈部坏死性筋膜炎病例进行了回顾性研究。最常见的病因是牙科感染,11例患者中有7例(64%)出现这种情况。大多数培养结果为无菌,因为所有这些患者在其他地方接受静脉抗生素治疗且未进行手术干预后才转诊至我们这里。在我们的管理下,患者平均住院21.6天,平均在全身麻醉下接受1.6次清创术。积极的伤口护理、广谱抗生素治疗和及时的手术干预使总体生存率达到91%(10/11),其中胸部扩展型患者的生存率为75%(3/4)。

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