诊断为坏死性筋膜炎的成年患者的评估:三年的经验

Abdifatah Ahmed, Nor Abdi Yasin, Sadettin Er
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摘要

本研究旨在探讨本院收治坏死性筋膜炎(NF)的诊断、随访及治疗经验。回顾性分析2017年1月1日至2020年1月1日在我院就诊的诊断为NF的患者的记录。评估患者的人口统计学特征、附加疾病、手术量、住院时间和治疗反应。20例NF患者均在我院随访治疗。其中男性15例(75%),女性5例(25%)。患者平均年龄53岁(最小28岁-最大80岁)。9例(45%)患者合并糖尿病。在感染部位方面,13例(65%)患者为腹壁(前、外侧和后区NF), 4例(20%)患者为胸壁(前、外侧和后区NF), 3例(15%)患者为肛周区富尼耶坏疽(继发于NF)。75%的患者接受双抗生素(头孢曲松+甲硝唑联合)治疗。然后,大多数患者进行了大量的清创和转移结肠造口手术,手术次数为1 ~ 6次(平均为2次)。17例(85%)患者在清创后采用负压缝合,3例(15%)患者采用开放性敷料。其中13例患者在我院进行植皮,4例(31%)患者采用手术皮瓣治疗。住院时间从90天到一天不等。这次是37(1-90)。本研究的死亡率为30%,其中一名患者在广泛清创后入院当天死亡。NF是一种很好的解耦器,它是一种非常简单的解耦器。
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Assessment of Adult Patients with a Diagnosis of Necrotizing Fasciitis: A Three-Year Experience
The aim of this study is to evaluate experiences about diagnosis, follow-up and treatment of necrotizing fasciitis (NF) patients who admitted to our hospital. The records of patients who had a diagnosis of NF that referred to our hospital between 01.01.2017 and 01.01.2020 were retrospectively analyzed. Patients' demographic feature, additional disease, amount of operations, length of hospital stay and responses for treatment was evaluated. All of 20 patients with NF were followed up and treated at our hospital. We found 15 (75%) of the patients were male and 5 (25%) were female. The mean age of the patients was 53 (Min: 28 -Max: 80). While nine (45%) of patients had diabetes mellitus. Concerning the site of infection, 13 (65%) patients had abdominal wall - (NF of the anterior, lateral and posterior regions), the four (20%) patients of NF involved the chest wall- (NF of the anterior and posterior regions), three (15%) patients perianal region with Fournier’s gangrene (secondary to NF). In 75%of patients received double antibiotic (ceftriaxone + metranidazole combination) therapy. Then, the majority of patients were exposed to lots of debridements and diversion colostomy, ranging from 1 to 6 surgeries (mean being two operations). Negative pressure wound closure was applied to 17 (85%) of the patients after debridement and three (15%) of the patients were treated with open dressing . Skin grafting was tackled in our hospital for 13 of these patients while four (31%) of the patients were treated with surgical flap methods. The length of hospital stay varies from 90 days to one day. This time was 37 (1-90). Mortality in this study was found to be 30%- one patient dying on the day of admission after the broad debridement. NF is a ve geniş debridman yeterli sonuçlara ulaştırabilir.
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