2例化脓性链球菌感染导致毒素休克综合征及坏死性筋膜炎病例分析

Two cases analysis of streptococcal toxin shock syndrome and necrotizing fasciitis caused by streptococcus pyogenes

目的探讨化脓性链球菌导致毒素休克综合征及坏死性筋膜炎的治疗方法。方法回顾性分析某院收治的2例化脓性链球菌感染患者的临床资料,总结治疗方法。化脓性链球菌感染并发链球菌毒素休克综合征及坏死性筋膜炎,具有发病急,进展快的特点,治疗上可予液体复苏、维持血压、补充凝血因子、抗感染、连续血液净化、提高免疫力、彻底清创引流等治疗。结果2例患者经治疗后感染得到控制,病情逐步好转,最后治愈出院。结论对于化脓性链球菌感染导致毒素休克综合征及坏死性筋膜炎的治疗,早期彻底的手术清创、有效的抗感染、人血白蛋白的使用、连续血液净化治疗等手段,具有良好的效果。

Objective To explore the therapeutic method of streptococcal toxin shock syndrome and necrotizing fasciitis caused by streptococcus pyogenes.Methods We retrospectively reviewed 2 cases of streptococcus pyogenes infection,summarize the treatment experience.The case 1 which was characterized by sudden occurrence,rapid change developed into streptococcal toxin shock syndrome and necrotizing fasciitis,our treatment included fluid resuscitation,maintenance of blood pressure,supplement of coagulation factors,anti infection,continuous blood purification,improve immunity,complete debridement drainage treatment.The case 2 developed into necrotizing fasciitis,our treatment included anti-infection,improve immunity,complete debridement drainage treatment.Results After treatment,the infection of 2 patients was controlled and their condition gradually improved.Conclusion For toxic shock syndrome and necrotizing fasciitis caused by streptococcus pyogenes,the treatments include surgical treatment,effective anti-infection,the use of human blood albumin,continuous blood purification,may play a vital role.