Stephens M B
Naval Hospital Bremerton, WA 98312, USA.
Postgrad Med. 1996 Apr;99(4):217-20, 224.
Clostridial myonecrosis (gas gangrene) is an uncommon sequela of traumatic injury. Infection with Clostridium perfringens in devitalized tissue is the most common cause. Wide surgical debridement and appropriate antibiotic therapy remain the standard of care. However, the addition of hyperbaric oxygen therapy to standard management has been shown to have a synergistic effect in reducing morbidity and mortality in both canine and murine models. Although no prospective human data are available, retrospective data indicate that concomitant hyperbaric oxygen therapy has resulted in a twofold reduction in mortality. Where feasible, hyperbaric oxygen therapy should routinely be incorporated into the treatment plan for gas gangrene. Primary care physicians are in a unique position not only to make an early diagnosis but also to have a central role in coordinating multidisciplinary care often needed for this potentially fatal infection.
梭菌性肌坏死（气性坏疽）是创伤性损伤罕见的后遗症。在失活组织中感染产气荚膜梭菌是最常见的原因。广泛的手术清创和适当的抗生素治疗仍然是标准的治疗方法。然而，在犬类和鼠类模型中，在标准治疗中加用高压氧治疗已显示出在降低发病率和死亡率方面具有协同作用。尽管尚无前瞻性的人类数据，但回顾性数据表明，联合高压氧治疗可使死亡率降低一半。在可行的情况下，高压氧治疗应常规纳入气性坏疽的治疗方案。初级保健医生不仅处于早期诊断的独特位置，而且在协调这种潜在致命感染通常所需的多学科护理方面发挥核心作用。
