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剖宫产术后腹部坏死性筋膜炎

[Abdominal necrotizing fasciitis after caesarean delivery].

作者信息

Barant S, Radbata D, Oberweis D, Jacobs D, Marecaux G, Zielonka E, Maréchal M

机构信息

Service de Gynécologie, Hôpital Erasme, Rue de la haie 59 bte 2, Ecaussinnes, Belgium.

Service de Gynécologie, Belgium.

出版信息

Rev Med Brux. 2016;37(3):178-182.

Abstract

Necrotizing fasciitis (NF) is a rare infection (0,2 to 0,4/100,000 adults) of the dermis and hypodermis extending along muscular fascia1. The absence of pathognomonic symptoms makes its diagnosis difficult. Rapidly progressive, it is a life-threatening emergency whose prognosis is letal in 30 % of cases. Treatment of necrotizing fasciitis is mixed and involves aggressive surgical debridement and medical treatment with antibiotics and supportive agents. This article is presenting the case of a young woman who developed abdominal necrotizing fasciitis following a caesarean section. In forty-eight hours, the patient developed septic shock with an extensive and rapid destruction of her abdominal wall. After hysterectomy and multiple surgical debridements, evolution was favorable. After one month, a reconstruction of the abdominal wall could be performed.

摘要

坏死性筋膜炎(NF)是一种罕见的真皮和皮下组织感染(成年人为0.2至0.4/10万),沿肌筋膜蔓延。缺乏特异性症状使其诊断困难。它进展迅速,是一种危及生命的急症,30%的病例预后致命。坏死性筋膜炎的治疗综合多样,包括积极的外科清创以及使用抗生素和支持药物进行药物治疗。本文介绍了一名年轻女性在剖宫产术后发生腹部坏死性筋膜炎的病例。在48小时内,患者出现感染性休克,腹壁广泛且迅速遭到破坏。在进行子宫切除和多次外科清创术后,病情好转。一个月后,可行腹壁重建术。

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