压疮并发坏死性软组织感染1例并文献复习

为了探究压疮并发坏死性软组织感染的诊治方法,报道了1例脊髓损伤截瘫和2型糖尿病患者坐骨和骶骨处压疮并发右侧臀部及右大腿外侧坏死性软组织感染的罕见病例,该病例的治疗方法包括联合应用大剂量多种抗生素,输液并用胰岛素注射控制血糖,局部处理压疮,外科清创术并扩大的筋膜切开术,辅以高压氧疗法治疗等,最后患者右侧臀部及右大腿外侧创面愈合。3处压疮溃疡愈合,结痂脱落,创面干燥愈合,上皮覆盖,表皮呈粉红色,周围皮肤色泽正常。病人住院35 d后出院。因此压疮并发坏死性软组织感染是一个危重的疾病,需要积极地内、外科治疗,才可能防止发生感染性休克乃至死亡的严重后果。该病例多种治疗手段联合应用的疗法值得推广。

A Rare Case of Necrotizing Soft Tissue Infections Complicated by Pressure Ulcer and Related Literature Review

To explore the diagnostics and treatment of necrotizing soft tissue infections complicated by pressure ulcer,the article reported a rare case of necrotizing soft tissue infections on right hip and right lateral thigh complicated by pressure ulcer suffering a patient with spinal cord injury paraplegia and type 2 diabetic.The treatment of the case included large doses of multiple antibiotics,infusion and insulin injection to control blood sugar,local treatment of pressure sores and surgical debridement and expanded fasciotomy,adjuvant hyperbaric oxygen therapy.At last the patient’s wounds on right hip and right lateral thigh were cured.3 pressure ulcers were cured,scab on them fell off.The wounds were dry and cured and were covered by epithelial cells.Epidermis appeared pink and skin around it appeared normal color.The patient was discharged after 35 days of hospital stay.So necrotizing soft tissue infections complicated by pressure ulcer are critical diseases that require internal and surgical treatment actively in case of serious consequences including infectious shock and even death.The therapty described in the article deserved to be popularized.