一例下肢被海鱼刺伤感染创伤弧菌报道并文献复习

A case report of Vibrio vulnificus infection in the lower limbs by sea fish stabbing and literature review

目的:总结和分析创伤弧菌脓毒症临床治疗经验,提高救治成功率。方法:对海南医学院第一附属医院重症医学科2019年10月份收治的1例创伤弧菌脓毒血症患者的临床资料进行分析,总结救治经验并与其它文献比较,分析目前最合理的创伤弧菌脓毒症临床治疗方法。结果:本例患者发病急,病情进展迅速,发热、软组织肿痛、坏死、破溃流脓、全身多个器官功能衰竭,家属最终放弃治疗,微生物学培养提示:副溶血弧菌。结论:创伤弧菌感染后早期干预、血液净化、扩大清创、清除感染源及炎症介质、防治DIC等多管齐下可提高患者生存率,由于该病死亡率高,临床医师应引起重视。

Objective:To summarize and analyze the clinical treatment experience of Vibrio vulnificus sepsis and to improve the success rate of treatment.Methods:The clinical data of a patient with Vibrio vulnificus sepsis admitted to the Department of Critical Care Medicine,the First Affiliated Hospital of Hainan Medical College in October 2019 was analyzed.The experience of treatment was summarized and compared with other literatures to analyze the most reasonable clinical treatment of Vibrio vulnificus sepsis.Results:The patient was acutely ill,the disease progressed rapidly,fever,soft tissue swelling and pain,necrosis,ulceration and pus,systemic multiple organ failure,family members finally gave up treatment,microbiology culture prompted:Vibrio parahaemolyticus.Conclusions:Early intervention,blood purification,debridement,removal of infection sources and inflammatory mediators can improve the survival rate of patients with Vibrio vulnificus infection.Due to the high mortality rate,clinicians should pay attention to it.