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三级护理中心坏死性筋膜炎的危险因素及其结局

Risk Factors For Necrotizing Fasciitis And Its Outcome At A Tertiary Care Centre.

作者信息

Gupta Yogendra, Chhetry Manisha, Pathak Kamal Raj, Jha Ranjib Kumar, Ghimire Nischal, Mishra Bibhuti Nath, Karn Navin Kumar, Singh Ganesh Kumar, Bhagabati Jatindra Nath

机构信息

Department of Orthopaedics and Trauma, Nobel Medical College Teaching Hospital and Research Centre, Biratnagar, Nepal.

Department of Obstetrics and Gynaecology, Nobel Medical College Teaching Hospital and Research Centre, Biratnagar, Nepal.

出版信息

J Ayub Med Coll Abbottabad. 2016 Oct-Dec;28(4):680-682.

Abstract

BACKGROUND

Necrotizing fasciitis (NF) is a serious and potentially fatal condition where there is rapid progression of inflammation of skin, subcutaneous tissue, and superficial fascia and can be mono-microbial or poly-microbial. The disease is rapidly progressive in nature and if not promptly treated leads to significant morbidity or even mortality. This study was designed to explore the various risk factors commonly present and study the outcome of the disease.

METHODS

This was a cross sectional study done in tertiary centre over period of one year from April 2014 to March 2015. Patient admitted with soft tissue infection were presumptively made diagnosis of NF based on clinical features and final diagnosis was made after pre-operative surgical findings.

RESULTS

Forty two (40.38%) patients had final diagnosis of NF out of 102 soft tissue infections. Twentynine (69%) of 42 patients with NF fully recovered with surgical and medical management. Eleven (26.2%) of these patients succumbed to their illness and two (4.8%) needed amputation of limb to control the infection. The most common co-morbid condition was alcoholism, followed by diabetes mellitus.

CONCLUSIONS

The incidence of necrotizing fasciitis in patients admitted with soft tissue infection was 40.38%. Mortality and morbidity due to this condition was found to be high.

摘要

背景

坏死性筋膜炎(NF)是一种严重且可能致命的疾病,其皮肤、皮下组织和浅筋膜的炎症进展迅速,可为单微生物感染或多微生物感染。该疾病本质上进展迅速,若不及时治疗会导致严重的发病率甚至死亡率。本研究旨在探究常见的各种风险因素并研究该疾病的结局。

方法

这是一项在三级医疗中心于2014年4月至2015年3月期间进行的为期一年的横断面研究。因软组织感染入院的患者根据临床特征初步诊断为NF,最终诊断在术前手术发现后确定。

结果

在102例软组织感染患者中,42例(40.38%)最终诊断为NF。42例NF患者中有29例(69%)通过手术和药物治疗完全康复。这些患者中有11例(26.2%)因病死亡,2例(4.8%)需要截肢以控制感染。最常见的合并症是酗酒,其次是糖尿病。

结论

因软组织感染入院患者中坏死性筋膜炎的发病率为40.38%。发现该疾病导致的死亡率和发病率很高。

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