Samuel M, Freeman N V, Vaishnav A, Sajwany M J, Nayar M P
Department of Pediatric Surgery, Royal Hospital, Muscat, Oman.
J Pediatr Surg. 1994 Nov;29(11):1414-6. doi: 10.1016/0022-3468(94)90133-3.
Necrotizing fasciitis occurs when the inflammation (cellulitis) spreads beyond the umbilicus to include the subcutaneous tissue and underlying fascia. Presently, omphalitis is relatively uncommon because of aseptic delivery techniques and antimicrobial therapy. One hundred three neonates aged 7 to 28 days, with varying degrees of omphalitis, were treated on an outpatient or inpatient basis between 1989 and mid-1993. The neonates were full-term and weighed at least 2.5 kg. Patients with necrotizing fasciitis initially appear deceptively well, which results in less-than-optimum treatment at the outset, followed by a rapid and fulminating downhill course, in turn resulting in death within 24 to 72 hours. Early recognition of the condition, with aggressive resuscitation, appropriate antibiotics, and early surgery are necessary to salvage this high-risk group. The risk factors that may predict the development of necrotizing fasciitis and its early detection are discussed.
当炎症（蜂窝织炎）扩散至脐部以外，累及皮下组织和深层筋膜时，就会发生坏死性筋膜炎。目前，由于无菌分娩技术和抗菌治疗的应用，脐炎相对并不常见。1989年至1993年年中，对103例年龄在7至28天、患有不同程度脐炎的新生儿进行了门诊或住院治疗。这些新生儿均为足月儿，体重至少2.5千克。坏死性筋膜炎患者最初看似情况良好，这导致一开始的治疗不够理想，随后病情迅速恶化，进而在24至72小时内死亡。早期识别病情、积极复苏、使用恰当的抗生素以及早期手术对于挽救这一高危群体是必要的。本文讨论了可能预测坏死性筋膜炎发生及其早期检测的危险因素。
