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《肛周坏死性筋膜炎诊断与治疗中国专家共识(2019年版)》

[Chinese expert consensus on diagnosis and treatment of perianal necrotizing fasciitis (2019)].

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2019 Jul 25;22(7):689-693. doi: 10.3760/cma.j.issn.1671-0274.2019.07.017.

Abstract

Perianal necrotizing fasciitis is a serious soft tissue infectious disease of perianal and perineal regions, where a synergistic action of multiple bacteria (including aerobic bacteria and anaerobic bacteria) results in suppurative necrosis of the skin and soft tissue. The disease progress may rapidly cause systemic sepsis through blood circulation, often with complicating shock and MODS, or death. Any delay in diagnosis and treatment of early acute infections may lead to higher mortality because of lack of standardized treatment. The Clinical Guidelines Committee aims to formulate expert consensus on the treatment of perianal necrotizing fasciitis in terms of etiology and pathology, clinical manifestations, laboratory and imaging study, preoperative preparation, surgical treatment (the application of antibiotics, the timing and key points of debridement, assistant therapy), postoperative wound care, nutritional support, surgical reconstruction and rehabilitation. This consensus is a reference for clinicians based on patient conditions.

摘要

肛周坏死性筋膜炎是一种发生于肛周和会阴区域的严重软组织感染性疾病,由多种细菌(包括需氧菌和厌氧菌)协同作用导致皮肤和软组织的化脓性坏死。疾病进展可能通过血液循环迅速引发全身性败血症,常伴有休克和多器官功能障碍综合征等并发症,甚至导致死亡。早期急性感染若诊断和治疗延误,由于缺乏标准化治疗,可能导致更高的死亡率。临床指南委员会旨在从病因病理、临床表现、实验室及影像学检查、术前准备、手术治疗(抗生素应用、清创时机及要点、辅助治疗)、术后伤口护理、营养支持、手术重建及康复等方面,制定关于肛周坏死性筋膜炎治疗的专家共识。本共识供临床医生根据患者具体情况参考。

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