Stamenkovic I, Lew P D
N Engl J Med. 1984 Jun 28;310(26):1689-93. doi: 10.1056/NEJM198406283102601.
Necrotizing fasciitis is a rare, rapidly progressing soft-tissue infection. Early clinical recognition is difficult, and there is often a fatal delay in appropriate treatment. We evaluated the use of frozen-section biopsies for the rapid diagnosis of this disease in its early stages. Nineteen cases of necrotizing fasciitis were studied over a 13-year period. In all eight cases in which frozen-section biopsy was performed within zero to four days (average, 21 hours) after the onset of symptoms, histologic study confirmed the diagnosis, and surgical d ebridement was immediately performed. Only one patient died. In 11 patients, the diagnosis was made on clinical grounds, and surgical therapy was delayed for 1 to 15 days (average, 6) after the onset of symptoms because of failure to recognize the disorder immediately. Eight patients died (P less than 0.02). Our study indicates that rapid performance of frozen-section soft-tissue biopsy early in the evolution of a suspect lesion may provide a definitive and life-saving diagnosis.
坏死性筋膜炎是一种罕见的、进展迅速的软组织感染。早期临床识别困难，在适当治疗方面往往存在致命延误。我们评估了冰冻切片活检在该病早期快速诊断中的应用。在13年期间研究了19例坏死性筋膜炎病例。在症状出现后0至4天（平均21小时）内进行冰冻切片活检的所有8例病例中，组织学研究证实了诊断，并立即进行了手术清创。仅1例患者死亡。在11例患者中，根据临床情况做出诊断，由于未能立即识别该疾病，手术治疗在症状出现后延迟了1至15天（平均6天）。8例患者死亡（P<0.02）。我们的研究表明，在可疑病变演变早期快速进行冰冻切片软组织活检可能提供明确的、挽救生命的诊断。
