Pillans P I, O'Connor N
Department of Pharmacology, University of Cape Town Medical School, South Africa.
Ann Pharmacother. 1995 Mar;29(3):264-6. doi: 10.1177/106002809502900307.
To report 6 cases of severe local reactions associated with intramuscular injection of diclofenac.
Three patients developed extensive tissue necrosis at the injection site after intramuscular diclofenac. Necrotizing fasciitis in an additional 3 patients was associated with complications such as adult respiratory distress syndrome, renal failure, shock, and disseminated intravascular coagulation. Organisms were cultured from the necrotic site in 3 cases. Two patients died.
Tissue necrosis is a rare but serious complication of intramuscular administration of medicines, including nonsteroidal antiinflammatory drugs (NSAIDs). Pain often occurs at the time of the injection, but tissue necrosis typically becomes apparent a few days later. Necrotizing fasciitis is characterized by rapidly spreading infection with necrosis of fascia and subcutaneous fat.
Intramuscular administration of diclofenac may be associated with severe tissue necrosis or necrotizing fasciitis. Although rare, these serious complications should be considered when intramuscular injection of NSAIDs is contemplated.
报告6例与肌肉注射双氯芬酸相关的严重局部反应。
3例患者在肌肉注射双氯芬酸后注射部位出现广泛组织坏死。另外3例患者发生坏死性筋膜炎，并伴有成人呼吸窘迫综合征、肾衰竭、休克和弥散性血管内凝血等并发症。3例患者坏死部位培养出微生物。2例患者死亡。
组织坏死是包括非甾体抗炎药（NSAIDs）在内的药物肌肉注射罕见但严重的并发症。注射时常常会出现疼痛，但组织坏死通常在数天后才变得明显。坏死性筋膜炎的特征是感染迅速扩散，伴有筋膜和皮下脂肪坏死。
肌肉注射双氯芬酸可能会导致严重组织坏死或坏死性筋膜炎。尽管罕见，但在考虑肌肉注射NSAIDs时应考虑到这些严重并发症。
