A Clinical Analysis of Necrotizing Fasciitis: A Review of 54 Cases

壞死性筋膜炎54例臨床分析

蔡志成(Chih-Cheng Tsai) ； 林幸道(Sin-Daw Lin) ； 賴春生(Chung-Sheng) ； 周治剛(Chih-Kang Chou)

《The Kaohsiung Journal of Medical Sciences》 11卷12期 (1995/12) Pp. 673-677

https://doi.org/10.6452/KJMS.199512.0673

摘要

壞死性筋膜炎是一種嚴重且有時會致命的皮下軟組織感染，其主要特徵在快速而且廣泛性皮下組織和筋膜的壞死。自 1989 年開始五年來，我們曾經治療過 54 個壞死性筋膜炎的病人，其中 25 個病人（46 % ）合併有糖尿病，這類疾病大都是多種細菌的混合感染，其主要的菌種依序是鏈球菌、葡萄球菌和大腸桿菌，在我們的病人中其死亡率是 22 % ( 12/54 ) ，死亡的造成皆是因敗血症所引起的併發症，所有死亡的病例，平均在症狀出現後 25 天，才接受清創手術治療，早期的診斷和作早期廣泛性清創手術對降低死亡率來說是很重要的

並列摘要

Necrotizing fasciitis is a severe and sometimes life-threatening soft tissue infection that is characterized by rapidly widespreading necrosis of fascia and subcutaneous tissue. Fifty-four cases of necrotizing fasciitis were reviewed over a 5-year period. Among them, 25 patients (46%) had diabetes mellitus. The majority of the wound bacterial cultures (71%) yielded a mixed growing. There were negative cultures in six patients, and single organism growth in 14 patients (29%). The predominant organisms growth were Streptococci, Staphylococci, and Escherichia coil. The overall mortality rate was 22% (12/54). Death was caused by systemic septic complications in these patients. All 12 mortalities resulted from delayed debridement (averaging 25 days after initial symptoms appeared). Our study indicates that the early recognition and prompt debridement of all necrotic tissue is essential for reducing the mortality rates of this potentially lethal condition.

並列關鍵字

necrotizing fasciitis ； surgical infection