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即时床旁超声在诊断坏死性筋膜炎中的应用:文献综述。

Point-of-care ultrasonography in diagnosing necrotizing fasciitis-a literature review.

机构信息

Unit for Research in Emergency and Disaster, Public Health Area, Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain.

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Ultrasound. 2023 Jun;26(2):343-353. doi: 10.1007/s40477-022-00761-5. Epub 2023 Jan 24.

Abstract

INTRODUCTION

Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the fascial layer with a high mortality rate. It is a life-threatening medical emergency that requires urgent treatment. Lack of skin finding in NF made diagnosis difficult and required a high clinical index of suspicion. The use of ultrasound may guide clinicians in improving diagnostic speed and accuracy, thus leading to improved management decisions and patient outcomes. This literature search aims to review the use of point-of-care ultrasonography in diagnosing necrotizing fasciitis.

METHOD

We searched relevant electronic databases, including PUBMED, MEDLINE, and SCOPUS, and performed a systematic review. Keywords used were "necrotizing fasciitis" or "necrotising fasciitis" or "necrotizing soft tissue infections" and "point-of-care ultrasonography" "ultrasonography" or "ultrasound". No temporal limitation was set. An additional search was performed via google scholar, and the top 100 entry was screened.

RESULTS

Among 540 papers screened, only 21 were related to diagnosing necrotizing fasciitis using ultrasonography. The outcome includes three observational studies, 16 case reports, and two case series, covering the period from 1976 to 2022.

CONCLUSION

Although the use of ultrasonography in diagnosing NF was published in several papers with promising results, more studies are required to investigate its diagnostic accuracy and potential to reduce time delay before surgical intervention, morbidity, and mortality.

摘要

简介

坏死性筋膜炎(NF)是一种筋膜层的快速进行性坏死,死亡率很高。它是一种危及生命的医疗紧急情况,需要紧急治疗。NF 缺乏皮肤表现,使得诊断变得困难,需要高度的临床怀疑指数。超声的使用可以帮助临床医生提高诊断速度和准确性,从而改善管理决策和患者预后。本文旨在综述床旁超声在诊断坏死性筋膜炎中的应用。

方法

我们检索了相关的电子数据库,包括 PUBMED、MEDLINE 和 SCOPUS,并进行了系统评价。使用的关键词为“坏死性筋膜炎”或“坏死性筋膜炎”或“坏死性软组织感染”和“床旁超声”“超声”或“超声”。没有设置时间限制。还通过谷歌学术进行了额外的搜索,并对前 100 项进行了筛选。

结果

在筛选出的 540 篇论文中,仅有 21 篇与使用超声诊断坏死性筋膜炎有关。结果包括三项观察性研究、16 篇病例报告和两项病例系列,涵盖了 1976 年至 2022 年的时期。

结论

尽管有几篇论文发表了关于超声在诊断 NF 中的应用的研究,结果有一定前景,但仍需要更多的研究来调查其诊断准确性以及减少手术干预前的时间延迟、发病率和死亡率的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52cc/10247625/ae8d57b5f04d/40477_2022_761_Fig1_HTML.jpg

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