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创伤弧菌原发性脓毒症2例

程大胜 纪世召 王光毅 朱峰 肖仕初 朱世辉

程大胜, 纪世召, 王光毅, 等. 创伤弧菌原发性脓毒症2例[J]. 中华烧伤与创面修复杂志, 2022, 38(3): 276-280. DOI: 10.3760/cma.j.cn501120-20201027-00448.
引用本文: 程大胜, 纪世召, 王光毅, 等. 创伤弧菌原发性脓毒症2例[J]. 中华烧伤与创面修复杂志, 2022, 38(3): 276-280. DOI: 10.3760/cma.j.cn501120-20201027-00448.
Cheng DS,Ji SZ,Wang GY,et al.Two cases of Vibrio vulnificus primary sepsis[J].Chin J Burns Wounds,2022,38(3):276-280.DOI: 10.3760/cma.j.cn501120-20201027-00448.
Citation: Cheng DS,Ji SZ,Wang GY,et al.Two cases of Vibrio vulnificus primary sepsis[J].Chin J Burns Wounds,2022,38(3):276-280.DOI: 10.3760/cma.j.cn501120-20201027-00448.

创伤弧菌原发性脓毒症2例

doi: 10.3760/cma.j.cn501120-20201027-00448
详细信息
    通讯作者:

    朱世辉,Email:doctorzhushihui@163.com

Two cases of Vibrio vulnificus primary sepsis

More Information
    Corresponding author: Zhu Shihui, Email: doctorzhushihui@163.com
  • 摘要: 本文对海军军医大学第一附属医院收治的2例创伤弧菌原发性脓毒症患者的临床资料进行总结分析,并综述最新文献。2019年11月6日收治1例54岁男性患者,其进食淡水水产品后双下肢红肿、疼痛明显,出现瘀斑及血性水疱,入院后3 h急诊行筋膜切开减张术,术后各脏器功能衰竭,入院后24 h放弃治疗。2020年8月12日收治1例73岁男性患者,其进食海鲜后右下肢出现血性水疱,入院时呈休克状态,入院后3 h急诊手术探查并行右大腿截肢,6 d后残端行负压伤口疗法,入院后13 d家属放弃积极治疗,入院后15 d患者死亡。2例患者均未能第一时间诊断,病情进展迅速,出现坏死性筋膜炎及多器官功能衰竭,明确诊断后分别予筋膜切开减张和高位截肢,微生物培养结果均为创伤弧菌。虽最终均未救治成功,但早期截肢患者病程及部分指标均优于切开减张者。创伤弧菌分布广泛,淡水水产品中多次检出,致病途径模糊复杂,极易误诊,宜建立创伤弧菌脓毒症救治流程,尽早积极手术干预,筋膜切开和清创应彻底,合并出血性大疱者应早期截肢,术后采用综合措施提高患者存活率。

     

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  • 1  例1患者创伤弧菌原发性脓毒症患者双下肢病变情况。1A.入院后1 h双小腿肿胀,可见皮下血性瘀斑、血性水疱形成,足背动脉消失;1B.双下肢筋膜切开减张术后7 h,可见筋膜肌肉无生机

    2  例2患者创伤弧菌原发性脓毒症患者右下肢处置情况。 2A.入院时右小腿及右足肿胀,可见皮下血性瘀斑、血性水疱;2B.紧急手术切开减张,见右小腿筋膜肌肉坏死,遂改行右大腿截肢术;2C.截肢术后6 d右大腿残端无明显感染,组织活力尚可

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  • 收稿日期:  2020-10-27

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