小儿坏死性筋膜炎28例临床分析

Necratic fasctis in children: a report of 28 cases

自1982年至1997年共收治小儿急性坏死筋膜炎28例,对其临床表现、辅助检查、诊断和治疗情况进行分析,以提高小儿急性坏死性筋膜炎的诊治水平,治疗的关键是及早多处切开引流,反复清创,大量双氧水冲洗以提高组织的氧化还原电位差,选用高度敏感的抗生素和支持疗法。病因及病变部位与成人不同,局部受压及患部污染是重要的致病因素,广泛性筋膜坏死、毒素吸收及扩创打击易使患儿全身衰竭、多种细菌混合感染应引起重视。

The paper reports 28 cases of Infantile Necrotic Fasoitis in the department of pediatrie surgery in Taizhou s Hospital during 1982-1997. Twenty-eight infants of acut necrotic fascibs were admitted. Combined with literatures following things were disscussed about the disease, including gists of diagnosis and methods of treatment. The treatment included early multiple incision and drainge repeated debridement and irrigation with 3% hydrogen peroxide solution,antibiotics and support therapy. We consider that the etiology and location of necrobc fascibs in infancy are different from those in adults. Local compression and contamination are die main pathogenic factors. More attention should be paid to the rapidly progressive infection in infancy caused by the coordination of various bacteria.