BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutane...BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.展开更多
目的:探究膝关节镜下引导小切口与传统切开内固定治疗胫骨平台骨折(fracture of tibial plateau,FTP)的效果及对膝关节功能的影响。方法:回顾性分析2022年6月—2023年3月厦门市第五医院收治的60例FTP患者,按照膝关节镜下引导小切口和传...目的:探究膝关节镜下引导小切口与传统切开内固定治疗胫骨平台骨折(fracture of tibial plateau,FTP)的效果及对膝关节功能的影响。方法:回顾性分析2022年6月—2023年3月厦门市第五医院收治的60例FTP患者,按照膝关节镜下引导小切口和传统切开内固定手术方式差异分为研究组(28例)和传统组(32例)。两组患者均于术后随访3个月,观察两组围手术期指标(手术时间、术中出血量、下床活动时间、骨折愈合时间、住院时间),统计两组随访期间并发症发生率,比较两组术前、术后48 h炎症应激指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、皮质醇(cortisol,Cor)]及术前、术后3个月膝关节功能评分[采用美国特种外科医院膝关节评分(Hospital for Special Surgery knee score,HSS)、膝关节活动度(range of motion,ROM)]。结果:研究组手术时间显著长于传统组,术中出血量显著少于传统组,下床活动时间显著早于传统组,差异有统计学意义(P<0.05);两组骨折愈合时间、住院时间比较,差异无统计学意义(P>0.05);研究组并发症总发生率低于传统组,差异有统计学意义(P<0.05);术后48 h,两组IL-6、TNF-α、Cor水平均较术前显著升高,但研究组术后48 h的IL-6、TNF-α、Cor水平显著低于传统组,差异有统计学意义(P<0.05);术后3个月,两组HSS评分、ROM中伸膝和屈膝角度均较术前显著升高,且研究组HSS评分、ROM伸膝和屈膝角度高于传统组,差异有统计学意义(P<0.05)。结论:膝关节镜下引导小切口与传统切开内固定手术治疗FTP均能取得较好临床效果,但膝关节镜下引导小切口式更具微创优势,可减少术中出血量、缩短下床活动时间,且并发症发生率低,术后炎症及应激反应轻,膝关节活动功能恢复好,有利于患者康复。展开更多
基金the Young Talent Program of LongHua Hospital Shanghai University of Traditional Chinese Medicine,No.RC-2019-01-01and the Shanghai Three-year Action Plan of Further Accelerated Development in Traditional Chinese Medicine,No.ZY(2018-2020)-CCCX-1007.
文摘BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.
文摘目的:探究膝关节镜下引导小切口与传统切开内固定治疗胫骨平台骨折(fracture of tibial plateau,FTP)的效果及对膝关节功能的影响。方法:回顾性分析2022年6月—2023年3月厦门市第五医院收治的60例FTP患者,按照膝关节镜下引导小切口和传统切开内固定手术方式差异分为研究组(28例)和传统组(32例)。两组患者均于术后随访3个月,观察两组围手术期指标(手术时间、术中出血量、下床活动时间、骨折愈合时间、住院时间),统计两组随访期间并发症发生率,比较两组术前、术后48 h炎症应激指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、皮质醇(cortisol,Cor)]及术前、术后3个月膝关节功能评分[采用美国特种外科医院膝关节评分(Hospital for Special Surgery knee score,HSS)、膝关节活动度(range of motion,ROM)]。结果:研究组手术时间显著长于传统组,术中出血量显著少于传统组,下床活动时间显著早于传统组,差异有统计学意义(P<0.05);两组骨折愈合时间、住院时间比较,差异无统计学意义(P>0.05);研究组并发症总发生率低于传统组,差异有统计学意义(P<0.05);术后48 h,两组IL-6、TNF-α、Cor水平均较术前显著升高,但研究组术后48 h的IL-6、TNF-α、Cor水平显著低于传统组,差异有统计学意义(P<0.05);术后3个月,两组HSS评分、ROM中伸膝和屈膝角度均较术前显著升高,且研究组HSS评分、ROM伸膝和屈膝角度高于传统组,差异有统计学意义(P<0.05)。结论:膝关节镜下引导小切口与传统切开内固定手术治疗FTP均能取得较好临床效果,但膝关节镜下引导小切口式更具微创优势,可减少术中出血量、缩短下床活动时间,且并发症发生率低,术后炎症及应激反应轻,膝关节活动功能恢复好,有利于患者康复。
