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颌面部软组织气性坏疽1例

2018-01-14 佚名 临床军医杂志

气性坏疽
关注

患者男性，61岁

【一般资料】

患者男性，61岁

【主诉】

因右侧颌面外伤后出现局部肿胀，疼痛1周，门诊以右侧颌面感染入院。

【体格检查】

神志清，问话能正确回答，查体合作。查右侧颌面部肿胀，皮肤张力增高，肿胀区中央有波动感，沿波动感周围有1个4cm×3cm黑色坏死区，皮肤有糜烂，表面有明显渗出物，恶臭，张口活动明显受限。血细胞分析：白细胞计数12.1×109个/L，中性94%。

【辅助检查】

CT扫描及B超提示，右侧颌面部软组织含气性感染，坏疽，

【初步诊断】

考虑为厌氧菌感染。

【治疗】

给予广谱抗生素治疗，局麻下行脓肿切开引流术，于右侧颌面部做1个4cm切口，可见局部皮肤坏死，皮下组织及肌肉呈褐色无结构液化状，上颌骨部分骨质有破坏，给予彻底清创，将病变组织送病理检查，报告显示右颌面部气性坏疽。标本直接涂片镜检，发现存在厌氧菌（图1）。经过3d治疗，患者坚决要求自动出院，出院后1周死亡。


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    2018-08-02 hb2008ye

    #气性坏疽#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1998686, encodeId=50ab199868655, content=<a href='/topic/show?id=34d163e94e0' target=_blank style='color:#2F92EE;'>#气性坏疽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63794, encryptionId=34d163e94e0, topicName=气性坏疽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Aug 02 02:40:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420402, encodeId=5a931420402bc, content=<a href='/topic/show?id=2221935219e' target=_blank style='color:#2F92EE;'>#软组织#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93521, encryptionId=2221935219e, topicName=软组织)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52913579937, createdName=qilu_qi, createdTime=Tue Jan 16 08:40:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278973, encodeId=7e602e8973ff, content=了解了解.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Jan 16 07:29:55 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278540, encodeId=7bd72e854027, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jan 14 23:22:53 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-16 qilu_qi

    #软组织#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1998686, encodeId=50ab199868655, content=<a href='/topic/show?id=34d163e94e0' target=_blank style='color:#2F92EE;'>#气性坏疽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63794, encryptionId=34d163e94e0, topicName=气性坏疽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Aug 02 02:40:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420402, encodeId=5a931420402bc, content=<a href='/topic/show?id=2221935219e' target=_blank style='color:#2F92EE;'>#软组织#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93521, encryptionId=2221935219e, topicName=软组织)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52913579937, createdName=qilu_qi, createdTime=Tue Jan 16 08:40:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278973, encodeId=7e602e8973ff, content=了解了解.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Jan 16 07:29:55 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278540, encodeId=7bd72e854027, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jan 14 23:22:53 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-16 1dd8c52fm63(暂无匿称)

    了解了解.学习学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1998686, encodeId=50ab199868655, content=<a href='/topic/show?id=34d163e94e0' target=_blank style='color:#2F92EE;'>#气性坏疽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63794, encryptionId=34d163e94e0, topicName=气性坏疽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Aug 02 02:40:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420402, encodeId=5a931420402bc, content=<a href='/topic/show?id=2221935219e' target=_blank style='color:#2F92EE;'>#软组织#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93521, encryptionId=2221935219e, topicName=软组织)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52913579937, createdName=qilu_qi, createdTime=Tue Jan 16 08:40:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278973, encodeId=7e602e8973ff, content=了解了解.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Jan 16 07:29:55 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278540, encodeId=7bd72e854027, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jan 14 23:22:53 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-14 changjiu

    学习一下谢谢

    0