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经闭孔吊带由内向外置入术后出现大腿脓肿及坏死性筋膜炎：一例报告

Thigh abscess and necrotizing fasciitis following an inside-out transobturator tape intervention: a case report.

作者信息

Kerbaj Jad, Aubry Camille, Prost Caroline, Brouqui Philippe

机构信息

Maladies Infectieuses et Tropicales, CHU Nord, AP-HM, Pôle des Maladies Infectieuses et Tropicales, Marseille, France.

Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France.

出版信息

J Med Case Rep. 2016 Jun 2;10(1):146. doi: 10.1186/s13256-016-0942-3.

DOI:10.1186/s13256-016-0942-3
PMID:27256334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4890333/
Abstract

BACKGROUND

Tension-free vaginal transobturator tapes are used worldwide in the treatment of urinary incontinence in women. Very few severe complications have been described following this procedure, with no standard treatment yet established.

CASE PRESENTATION

We present the case of a 36-year-old French white woman with no remarkable medical history, presenting with an abscess and necrotizing fasciitis 48 hours after an inside-out tension-free transobturator procedure. Samples were collected by guided puncture from the abscess, retrieving Staphylococcus aureus and Citrobacter koseri.

CONCLUSIONS

Severe complications following this procedure are rare, although it can have the potential for significant morbidity and even mortality, which is worth highlighting. We recommend early surgical treatment in combination with broad-spectrum antibiotics and coverage for Staphylococcus aureus, which may be a causative agent.

摘要

背景

无张力经闭孔阴道吊带术在全球范围内用于治疗女性尿失禁。该手术后极少有严重并发症的报道，且尚未确立标准治疗方法。

病例报告

我们报告一例36岁法国白人女性病例，其既往无显著病史，在由外向内无张力经闭孔手术后48小时出现脓肿和坏死性筋膜炎。通过引导穿刺从脓肿中采集样本，检出金黄色葡萄球菌和科氏柠檬酸杆菌。

结论

该手术后严重并发症罕见，尽管其有导致严重发病甚至死亡的可能性，这一点值得强调。我们建议早期手术治疗并联合使用广谱抗生素，针对可能的病原体金黄色葡萄球菌进行覆盖治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/093d4501d35e/13256_2016_942_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/d09fe9eadb35/13256_2016_942_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/585bc42ec93d/13256_2016_942_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/093d4501d35e/13256_2016_942_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/d09fe9eadb35/13256_2016_942_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/585bc42ec93d/13256_2016_942_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1054/4890333/093d4501d35e/13256_2016_942_Fig3_HTML.jpg

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本文引用的文献

1
Necrotising soft tissue infections: the effect of hyperbaric oxygen on mortality.坏死性软组织感染：高压氧对死亡率的影响
Anaesth Intensive Care. 2015 Nov;43(6):685-92. doi: 10.1177/0310057X1504300604.
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Retropubic tension-free vaginal tape and inside-out transobturator tape: a long-term randomized trial.耻骨后无张力阴道吊带术与经闭孔由内向外吊带术：一项长期随机试验
Int Urogynecol J. 2016 Jan;27(1):103-11. doi: 10.1007/s00192-015-2798-2. Epub 2015 Aug 12.
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Medium-term and long-term outcomes following placement of midurethral slings for stress urinary incontinence: a systematic review and metaanalysis.
用于治疗压力性尿失禁的中段尿道吊带置入术后的中长期结局：一项系统评价和荟萃分析。
Int Urogynecol J. 2015 Sep;26(9):1253-68. doi: 10.1007/s00192-015-2645-5. Epub 2015 May 20.
4
Assessment of perioperative, early, and late postoperative complications of the inside-out transobturator tape procedure in the treatment of stress urinary incontinence.经闭孔尿道中段吊带术治疗压力性尿失禁围手术期、术后早期及晚期并发症的评估
Clin Exp Obstet Gynecol. 2015;42(1):82-9.
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Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings.耻骨后与由外向内及由内向外经闭孔尿道中段吊带术对排尿功能的12个月影响
Int Urogynecol J. 2012 Feb;23(2):197-206. doi: 10.1007/s00192-011-1543-8. Epub 2011 Sep 2.
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Evaluation of transobturator tension-free vaginal tapes in management of women with recurrent stress urinary incontinence.经闭孔无张力阴道吊带术治疗复发性压力性尿失禁的效果评价。
Urology. 2011 May;77(5):1070-5. doi: 10.1016/j.urology.2011.01.016. Epub 2011 Mar 17.
7
Acute and serious myositis with abscess in thigh muscle after transobturator tape implantation.经闭孔吊带植入术后大腿肌肉急性严重肌炎伴脓肿。
Int Neurourol J. 2010 Oct;14(3):182-5. doi: 10.5213/inj.2010.14.3.182. Epub 2010 Oct 31.
8
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Int Urogynecol J. 2010 Nov;21(11):1321-6. doi: 10.1007/s00192-010-1195-0. Epub 2010 Jun 18.
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Urol Int. 2008;81(4):483-5. doi: 10.1159/000167853. Epub 2008 Dec 10.
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