急性坏死性眶周筋膜炎。临床病例

Natalia N. Haritonova, D. Gorbachev, Maksim S. Safonov, A. A. Kolbin, A. Kulikov, Alena A. Kolke, I. Batyrshin, E. Zinoviev
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引用次数: 0

摘要

背景:一种罕见的严重坏死性眶周筋膜炎,其特征是某些部位的高死亡率(高达70%),以前在国内文献中没有描述过。目的:以临床病例为例,介绍一种多学科治疗和康复眶周坏死性筋膜炎的方法。临床病例:患者急性双眼皮坏死性筋膜炎,扩散至面部和颈部浅表筋膜炎,并发败血症。监测生命功能、体内平衡指标、重复接种、计算机断层扫描、眼科医生的定期检查,包括控制视觉功能、前段和后段、闭合眼裂。介绍了由多学科团队应用保守和手术治疗,挽救了患者的生命,跨越了化脓性坏死,然后是粗糙的疤痕过程,并取得了令人满意的解剖和功能结果。结论:及时对眶周坏死性筋膜炎进行多学科治疗,对于挽救生命、预防眼部严重并发症是必要的。由于存在发展为拉格眼的威胁,有必要在第一次手术后进行36个月的永久性睑缘修复术,并对疤痕过程进行进一步的手术和药物矫正。
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The acute necrotizing periorbital fasciitis. Clinical case
BACKGROUND: A rare severe, characterized by high mortality in some localizations (up to 70%) necrotizing periorbital fasciitis has not been described previously in the national literature. AIM: to show a multidisciplinary approach to the treatment and rehabilitation of patients with periorbital necrotizing fasciitis on the example of the clinical case. CLINICAL CASE: Patient with the acute necrotizing fasciitis of both eyelids, with the dissemination to the superficial face and neck fascies, the sepsis development is given. Monitoring of vital functions, homeostasis indicators, repeated inoculations, computed tomography, regular examination by an ophthalmologist included the control of visual functions, anterior and posterior segments, closure of the eye fissure. Conservative and surgical treatment applied by a multidisciplinary team is presented, which allowed to save the patients life, overpass the purulent-necrotic, and then the rough scar process and to achieve satisfactory anatomical and functional results. CONCLUSION: Timely multidisciplinary treatment of periorbital necrotizing fasciitis is necessary for the life preservation, prevention of severe complications from the eye. With the threat of developing lagophthalmos, it is necessary to perform permanent blepharoraphy for 36 months after the first surgery and further surgical and pharmacological correction of scarring processes.
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
24
审稿时长
6 weeks
期刊最新文献
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