坏死性筋膜炎1例

A case of necrotizing fasciitis

报告1例坏死性筋膜炎。患者女,57岁。右手背及上肢红肿热痛伴溢脓4d。切开引流见皮下组织及筋膜广泛坏死、液化。皮损组织病理检查示,纤维蛋白样坏死及大量中性粒细胞浸润,脓肿形成。患者乙肝病史多年,住院期间出现大量腹水。经抗生素治疗、局部清创、反复输新鲜血浆和白蛋白,病情稳定,后经植皮痊愈。

A 57-year-old female had red swelling with pain on her right arm and the back of the hand for four days. Incision and debridement showed massive liquefied necrosis in subcutaneous tissue and fascia. The histological features were fibrinoid necrosis, a great number of polymorphonuclear leukocyte infiltration and pustules. The patient had a history of HBV infection. During hospitalization, ascites occurred. The patient was treated with antibiotics, debridement and repeated blood and albumin transfusions. After skin graft, she was fully recovered.