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坏死性筋膜炎——两例病例报告及文献复习。

Necrotizing fasciitis - two case reports and literature review.

机构信息

Jan Kochanowski University Medical College, Department of General Surgery, St. Alexander Hospital in Kielce, Kielce, Poland.

Department of General Surgery, St. Alexander Hospital in Kielce, Kielce, Poland.

出版信息

Pol Przegl Chir. 2023 Nov 24;96(0):103-108. doi: 10.5604/01.3001.0053.9501.

DOI:10.5604/01.3001.0053.9501
PMID:38348986
Abstract

<b><br>Introduction:</b> Necrotizing fasciitis (NF) is a rare, rapidly progressing infection of the skin and subcutaneous tissue. NF can lead to massive tissue necrosis, resulting in sepsis, septic shock and death. In this disease, it is important to quickly diagnose and implement appropriate treatment.</br> <b><br>Aim:</b> Analysis of the diagnostic and therapeutic process in two clinical cases and a review of the literature on the methods of diagnosis and treatment of necrotizing fasciitis.</br> <b><br>Material and methods:</b> The medical data of two patients hospitalized in the St Alexander Hospital in Kielce from December 2022 to June 2023 due to necrotizing fasciitis were analyzed. Also literature search across PubMed, Medline and Research Gate databases from 2000 up to 2023 was performed. We reviewed English literature according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The following keywords were used: necrotizing fasciitis, etiopathogenesis, pathophysiology, management.</br> <b><br>Results:</b> The research group consisted of two male patients with NF after trauma, in different parts of the body. Based on the clinical examination, the results of laboratory and imaging tests, a diagnosis was made and appropriate treatment was initiated. Despite the applied treatment, one patient died as a result of progressive multiple organ failure.</br> <b><br>Conclusions:</b> Despite advances in diagnosis and treatment, including universal access to antibiotics, necrotizing fasciitis still cause high mortality. The microbiological complexity of the majority of cases and non-specific symptoms make the diagnostic and therapeutic process difficult. Taking into account necrotizing fasciitis each time in the differential diagnosis of inflammation of the skin and subcutaneous tissue, especially based on trauma, will allow to reduce morbidity and mortality in this disease.</br&gt.

摘要

<b><br>引言:</b>坏死性筋膜炎(NF)是一种罕见的、迅速进展的皮肤和皮下组织感染。NF 可导致大量组织坏死,进而导致脓毒症、感染性休克和死亡。在这种疾病中,快速诊断和实施适当的治疗非常重要。</br> <b><br>目的:</b>分析两例临床病例的诊断和治疗过程,并对坏死性筋膜炎的诊断和治疗方法进行文献复习。</br> <b><br>材料和方法:</b>分析了 2022 年 12 月至 2023 年 6 月期间因坏死性筋膜炎在凯尔采的亚历山大医院住院的两名患者的医疗数据。还对 2000 年至 2023 年期间在 PubMed、Medline 和 Research Gate 数据库进行了文献检索。我们根据系统评价和荟萃分析的首选报告项目(PRISMA)指南对英文文献进行了回顾。使用了以下关键词:坏死性筋膜炎、病因发病机制、病理生理学、治疗。</br> <b><br>结果:</b>研究组由两名男性患者组成,他们因创伤分别在身体不同部位患有 NF。基于临床检查、实验室和影像学检查结果,做出了诊断并开始了适当的治疗。尽管进行了治疗,但一名患者因进行性多器官衰竭而死亡。</br> <b><br>结论:</b>尽管在诊断和治疗方面取得了进展,包括普遍获得抗生素,但坏死性筋膜炎仍然导致高死亡率。大多数病例的微生物学复杂性和非特异性症状使得诊断和治疗过程变得困难。在每次对皮肤和皮下组织炎症进行鉴别诊断时,特别是基于创伤的情况下,都考虑坏死性筋膜炎,将有助于降低这种疾病的发病率和死亡率。</br&gt。

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