頭頸部的壞死性肌膜炎－六例報告

Necrotizing Fasciitis of the Head and Neck – Report of Six Cases

蘇煜文(Yu-Wen Su) ； 張雅慧(Ya-Huei Chang) ； 王國榮(Kuo-Rong Wang) ； 周延隆(Yen-Long Jou) ； 呂志正(Chih-Cheng Lu) ； 薛智峰(Jee-Fong Hsueh)

《中華民國耳鼻喉科醫學雜誌》 34卷1期 (1999/01) Pp. 78-83

https://doi.org/10.6286/1999.34.1.78

摘要

頭頸部壞死性肌膜炎是一種快速進展的軟組織感染，且有極高的致病率及致死率。其特徵是皮下組織和肌膜大量壞死，而且會破壞鄰近的組織，甚至於造成敗血症，休克。由於頭頸部壞死性肌膜炎並不常見，易在初期忽略。故欲成功的治療此病，實需有高度警覺性，再加上積極的手術擴創治療和適宜的廣效抗生素使用。我們蒐集本科自1991年至1997年來的6例病例，作一回溯性分析，將病人過去的病史，臨床檢查診斷，治療方式及結果等記錄，綜合報告，並與過去報告比較，並加以討論。

關鍵字

壞死性肌膜炎 ； 頭頸部

並列摘要

Necrotizing fasciitis of the head and neck is a rapidly progressive soft tissue infection with high morbidity and mortality rates. The manifestations of this infection are extensive dissection and necrosis of the subcutaneous tissue and the superficial and/or deep fasciae with resultant widespread undermining of the adjacent tissue and extreme systemic toxicity. It is a rare condition and is usually mistaken in the initial diagnosis. Successful management of this infection requires early diagnosis, aggressive surgical debridement and prompt institution of broad spectrum antibiotics to control the infection. This report collects six cases of necrotizing fasciitis of the head and neck diagnosed in our department from 1991 through 1997. Based on our experience and the review of previous reports, the clinical manifestation, diagnosis and management of necrotizing fasciitis in the head and neck area are discussed.

並列關鍵字

necrotizing fasciitis ； head and neck