Aasen A O, Ruud T E, Haffner J, Raeder M, Solheim K, Stadaas J O, Sunde S, Skulberg A, Skjennald A, Melby K
Tidsskr Nor Laegeforen. 1989 Sep 30;109(27):2768-72.
We present nine patients with necrotizing fasciitis. Two of them had Fourniers gangrene. Predisposing factors included diabetes mellitus, alcohol and drug abuse. Local signs were redness, swelling and pain rapidly followed by fever and deterioration in the patient's general condition. Soft tissue-gas was observed in all patients. It was found either clinically, on roentgenograms or by CT. Bacteria were found in blood cultures and/or necrotic tissues in all patients. The dominating treatment was radical surgical excision and early reexplorations. Antibiotics, intensive care support and early parenteral nutrition were given. Four patients were given hyperbaric oxygen treatment. The overall mortality rate was 11%. Amputation of one lower extremity became necessary in three patients. In these cases 4-8 days had elapsed between the onset and the first surgical excision. We find it important to underline early diagnosis and radical surgical excision in patients with necrotizing fasciitis.
我们报告了9例坏死性筋膜炎患者。其中2例患有福尼尔坏疽。诱发因素包括糖尿病、酗酒和药物滥用。局部症状为发红、肿胀和疼痛，随后迅速出现发热和患者全身状况恶化。所有患者均观察到软组织积气，可通过临床检查、X线片或CT发现。所有患者的血培养和/或坏死组织中均发现细菌。主要治疗方法是根治性手术切除和早期再次探查。给予抗生素、重症监护支持和早期肠外营养。4例患者接受了高压氧治疗。总死亡率为11%。3例患者需要截肢一条下肢。在这些病例中，从发病到首次手术切除间隔了4至8天。我们认为强调坏死性筋膜炎患者的早期诊断和根治性手术切除很重要。
