Department of Surgery, Traumasurgery Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
Department of Medical Microbiology, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
World J Emerg Surg. 2016 May 27;11:21. doi: 10.1186/s13017-016-0080-7. eCollection 2016.
Necrotizing fasciitis is a rare, life threatening soft tissue infection, primarily involving the fascia and subcutaneous tissue. In a large cohort of patients presenting with Necrotizing fasciitis in the Netherlands we analysed all available data to determine the causative pathogens and describe clinical management and outcome.
We conducted a retrospective, multicentre cohort study of patients with a necrotizing fasciitis between January 2003 and December 2013 in an university medical hospital and three teaching hospitals in the Netherlands. We only included patients who stayed at the Intensive Care Unit for at least one day.
Fifty-eight patients were included. The mortality rate among those patients was 29.3 %. The central part of the body was affected in 28 patients (48.3 %) and in 21 patients (36.2 %) one of the extremities. Most common comorbidity was cardio vascular diseases in 39.7 %. Thirty-nine patients (67.2 %) were operated within 24 h after presentation. We found a type 1 necrotizing fasciitis in 35 patients (60.3 %) and a type 2 in 23 patients (39.7 %).
Our study, which is the largest study in Europe, reaffirmed that Necrotizing fasciitis is a life threatening disease with a high mortality. Early diagnosis and adequate treatment are necessary to improve the clinical outcome. Clinical awareness off necrotizing fasciitis remains pivotal.
坏死性筋膜炎是一种罕见的、危及生命的软组织感染，主要累及筋膜和皮下组织。在荷兰一个大型的坏死性筋膜炎患者队列中，我们分析了所有可用的数据，以确定病原体，并描述临床管理和结果。
我们对 2003 年 1 月至 2013 年 12 月期间在荷兰一所大学附属医院和三所教学医院的坏死性筋膜炎患者进行了回顾性、多中心队列研究。我们只纳入了至少在重症监护病房住过一天的患者。
共纳入 58 例患者。这些患者的死亡率为 29.3%。28 例（48.3%）患者的身体中部受到影响，21 例（36.2%）患者的四肢受到影响。最常见的合并症是心血管疾病，占 39.7%。39 例（67.2%）患者在发病后 24 小时内接受了手术。我们发现 35 例（60.3%）为 1 型坏死性筋膜炎，23 例（39.7%）为 2 型坏死性筋膜炎。
我们的研究是欧洲最大的研究，再次证实了坏死性筋膜炎是一种危及生命的疾病，死亡率很高。早期诊断和适当的治疗是改善临床结果所必需的。对坏死性筋膜炎的临床认识仍然至关重要。
