| 孙法同,贾代良.坏死性筋膜炎研究进展[J].济宁医学院学报,2020,43(5):366-371 |
| 坏死性筋膜炎研究进展 |
| Research progress of necrotizing fasciitis |
| 投稿时间：2020-06-17 |
| DOI：10.3969/j.issn.1000-9760.2020.05.014 |
| 中文关键词: 坏死性筋膜炎;溶血性链球菌;诊断;治疗 |
| 英文关键词: Necrotizing fasciitis;Streptococcus haemolyticus;Diagnosis;Treatment |
| 基金项目:济宁医学院国家自然（社会）科学基金培育项目（JYP2019KJ17） |
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| 摘要点击次数: 1927 |
| 全文下载次数: 1725 |
| 中文摘要: |
| 坏死性筋膜炎（NF）是一种严重的具有潜在致命性的侵袭性感染，其特征是皮肤、皮下组织和浅筋膜的快速广泛坏死。其诱因多见于糖尿病、肿瘤、营养不良、肝硬化、肾功能衰竭、自身免疫性疾病等。疾病早期会出现皮肤表现，局部红、肿、热、痛、硬，中期皮肤表面水疱增多变大，晚期可表现为持续高热、感染性休克及多器官功能衰竭，死亡率极高。LRINEC评分系统、CT、MRI有助于该疾病的诊断，手指实验被认为是诊断NF的最佳方法。NF的治疗原则是尽早诊断，清创引流，对症治疗，积极抗感染。另外，高压氧（HBO）以及负压封闭引流技术（VSD）对创面的早期愈合也有促进作用。本文将对NF的流行病学、发病机制、临床表现、诊断及治疗进展做一综述。 |
| 英文摘要: |
| Necrotizing fasciitis (NF) is a severe and potentially fatal invasive infection characterized by rapid and extensive necrosis of the skin,subcutaneous tissue and superficial fascia.The inducements are mainly caused by diabetes,tumor,malnutrition,liver cirrhosis,renal failure,autoimmune diseases and so on.There will be skin manifestations in the early stage of the disease,with local redness,swelling,heat,pain and hardness,and blisters on the skin surface increase and enlarge in the middle stage,while persistent high fever,septic shock and multiple organ failure can be seen in the late stage,with a high mortality rate.LRINEC scoring system,CT and MRI are helpful to the diagnosis of the disease,and finger test is considered to be the best method for the diagnosis of NF.The treatment principles of NF are early diagnosis,debridement and drainage,symptomatic treatment and active anti-infection.In addition,hyperbaric oxygen (HBO) and vacuum sealing drainage (VSD) can also promote early wound healing.This article reviews the epidemiology,pathogenesis,clinical manifestations,diagnosis and treatment of NF. |
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