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在金奈一家三级医院就诊的患者中,使用坏死性筋膜炎实验室风险指标(LRINEC)评分评估坏死性筋膜炎的分布情况。

Distribution of Necrotizing fasciitis Using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score Among Patients Attending a Tertiary Hospital in Chennai.

作者信息

Ramesh Arjun Aravindh, Selvaraj Karthikeyan, K Barathi Raja, C Srinivasan

机构信息

Department of Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.

Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.

出版信息

Cureus. 2024 Nov 15;16(11):e73755. doi: 10.7759/cureus.73755. eCollection 2024 Nov.

Abstract

Background (NF) is a rapidly progressing infection with a high mortality rate, requiring prompt diagnosis and treatment. The Laboratory Risk Indicator for NF (LRINEC) score has emerged as a useful tool for early risk stratification. Methods A cross-sectional study was conducted on 112 patients diagnosed with NF in a tertiary hospital in Chennai. Clinical data, including LRINEC scores and associated laboratory parameters, were collected and analyzed. The relationship between LRINEC scores and risk factors, such as gender, comorbidities (diabetes mellitus [DM] and peripheral vascular disease [PVD]), recent trauma, C-reactive protein (CRP) levels, white blood cell count (WBC) counts, and creatinine levels, was assessed. The treatment approaches and complications were also reviewed. Results The LRINEC score effectively stratified patients: 51.8% were at low risk, 33.9% at moderate risk, and 14.3% at high risk. Significant associations were found between higher LRINEC scores and elevated CRP, WBC count, creatinine levels, and low sodium levels (p < 0.001). DM and PVD were important comorbidities influencing disease severity. Conservative treatments, including hygroscopic dressings and antibiotics, were successful in 83.9% of cases, while 16.1% required surgical debridement. Complications included delayed wound healing (14.3%) and skin grafting (1.8%). Conclusion The LRINEC score is an effective tool for the early diagnosis and stratification of NF. Its use in clinical practice helps guide decision-making, particularly regarding early interventions and improving patient outcomes.

摘要

背景

坏死性筋膜炎(NF)是一种进展迅速、死亡率高的感染性疾病,需要及时诊断和治疗。坏死性筋膜炎实验室风险指标(LRINEC)评分已成为早期风险分层的有用工具。方法:对金奈一家三级医院确诊为NF的112例患者进行横断面研究。收集并分析包括LRINEC评分及相关实验室参数在内的临床数据。评估LRINEC评分与性别、合并症(糖尿病[DM]和外周血管疾病[PVD])、近期创伤、C反应蛋白(CRP)水平、白细胞计数(WBC)及肌酐水平等风险因素之间的关系。还回顾了治疗方法及并发症。结果:LRINEC评分有效地对患者进行了分层:51.8%为低风险,33.9%为中度风险,14.3%为高风险。LRINEC评分较高与CRP升高、WBC计数、肌酐水平及低钠水平之间存在显著相关性(p<0.001)。DM和PVD是影响疾病严重程度的重要合并症。包括吸湿敷料和抗生素在内的保守治疗在83.9%的病例中取得成功,而16.1%的患者需要手术清创。并发症包括伤口愈合延迟(14.3%)和植皮(1.8%)。结论:LRINEC评分是NF早期诊断和分层的有效工具。在临床实践中使用该评分有助于指导决策,特别是在早期干预和改善患者预后方面。

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Practical Review of Necrotizing Fasciitis: Principles and Evidence-based Management.坏死性筋膜炎实用综述:原则与循证管理
Plast Reconstr Surg Glob Open. 2024 Jan 19;12(1):e5533. doi: 10.1097/GOX.0000000000005533. eCollection 2024 Jan.
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Necrotizing Fasciitis.坏死性筋膜炎
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