Meltzer R M, Engel E D, Turf R
J Foot Surg. 1983 Summer;22(2):126-33.
Gas gangrene is a rare complication of elective surgery. Caused by several species of Clostridia, it is an acute, highly invasive necrotizing infection of muscle and fascia often leading to coma and death. Gas gangrene should be suspected if the patient has unremitting pain, high temperature, tachycardia, and prostration. Edema, brown watery exudate emanating from he wound, evidence of gas in tissues, and gram-positive rods on smear support the clinical diagnosis. Rapid surgical decompression and debridement is the basis of treatment. Adjuvant antibiotic, hyperbaric oxygen, antitoxin, local, and supportive therapies aid in treatment. The authors review the literature and discuss etiologies, pathogenesis, clinical features, and treatment.
气性坏疽是择期手术中一种罕见的并发症。由几种梭菌属细菌引起，是一种急性、具有高度侵袭性的肌肉和筋膜坏死性感染，常导致昏迷和死亡。如果患者出现持续疼痛、高热、心动过速和虚脱，应怀疑气性坏疽。伤口出现水肿、褐色水样渗出物、组织中有气体的迹象以及涂片显示革兰氏阳性杆菌，这些都支持临床诊断。快速手术减压和清创是治疗的基础。辅助性抗生素、高压氧、抗毒素、局部治疗和支持性治疗有助于治疗。作者回顾了文献并讨论了病因、发病机制、临床特征和治疗方法。
