肛周脓肿致大面积急性坏死性筋膜炎及阴囊坏疽一例并文献复习-急诊医学专业论文.docxVIP

华中科技大学 硕士学位论 华 中 科 技 大 学 硕 士 学 位 论 文 PAGE 10 PAGE 10 肛周脓肿致大面积急性坏死性筋膜炎及阴囊坏疽一例 并文献复习 华中科技大学同济医学院附属协和医院急诊科 430022 硕士研究生：涂志刚 导师：蒋春舫 教授 中文摘要 目的 提高临床医生对急性坏死性筋膜炎及阴囊坏疽的认识。 方法 结合肛周脓肿致大面积急性坏死性筋膜炎及阴囊坏疽一例的诊治过程，复习相 关文献，对其病因、发病机制、临床表现及诊治特点进行分析。 结果 急性坏死性筋膜炎及阴囊坏疽大多是由多因素致病，起病急，进展快，危害极 大，处理相当困难的软组织感染性疾病。多数可经多次及时手术切开清除坏死 组织、创面冲洗换药及抗休克、抗感染，加强营养支持等对症治疗后治愈。 结论 急性坏死性筋膜炎及阴囊坏疽是罕见病，但近年来国内外报道增多，且发病早 期与其他软组织感染如丹毒、蜂窝织炎及气性坏疽等难以鉴别，尽管现代医学 发展迅速，但误诊率仍较高，故早期诊断与及时适当治疗可明显减少病死率与 术后并发症。 关键词 坏死性筋膜炎；阴囊坏疽；肛周脓肿；清创 Perianorectal abscess lead to large area of acute necrotizing fasciitis and scrotum gangrene：a case report and review of the literature Department of Emergency, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Master candidate: Tu Zhigang Supervisor: Prof. Jiang Chunfang Abstract Objective To improve the awareness of acute necrotizing fasciitis and scrotum gangrene for clinicians. Method One case of large area of acute necrotizing fasciitis and scrotum gangrene was reported, and related literatures were reviewed to explore the etiology, pathogenesis, clinical presentations, and characters of diagnosis and treatment of acute necrotizing fasciitis and scrotum gangrene. Results Most of acute necrotizing fasciitis and scrotum gangrene are caused by multiple factors, which belong to the soft tissue of infectious that have disease urgent, rapidly spreading, potentially fatal and difficultly to deal with. Most patients can be cured after repeatedly treated via radical debridement and wound irrigation in time, also needed resistance to shock or infection and strengthen nutritional support. Conclusions Acute necrotizing fasciitis and scrotum gangrene are rare disease, but the reported increased at home and abroad in recent years. However, modern medicine technology development quickly, as it is hard to distinguish them from the other soft tissue infections such as erysipelas, cellulitis, and gas gangrene by the early clinical manifestations of the disease, the misdi