成功救治新生儿急性阴囊坏死性筋膜炎1例并文献复习

摘要/Abstract

摘要：

目的：结合1例新生儿急性坏死性筋膜炎的诊治探讨其临床诊断和治疗要点。方法：回顾性分析1例新生儿急性阴囊
坏死性筋膜炎的临床资料，通过检索PubMed 、迈特思创（METSTR）、中国知网（CNKI）、万方（WANFANG）等数据库2019年1月
10日前的报道并复习相关文献资料，对新生儿急性坏死性筋膜炎进行系统性综述。结果：本例新生儿阴囊坏死性筋膜炎经手
术、抗休克治疗后术后9 d痊愈出院。检索到关于新生儿坏死性筋膜炎的中英文文献共159篇，排除综述和重复计算病例的文
章后共计符合要求的文章53篇，报道病例数184例，仅16例发生于会阴部，病例数最多的1篇为20例，平均每篇3.5例，男孩93
例、女孩91 例。184 例患儿中115 例治愈，治愈率62.5%；69 例死亡，病死率37.5%，其中58 例为手术后死亡，术后死亡率
33.5%；另11例拒绝手术者均死亡。结论：新生儿坏死性筋膜炎病情发展迅速、预后极其凶险、病死率高，一经诊断应积极纠正
内环境紊乱和抗感染治疗，早期大范围病灶切开引流术或坏死性组织清除术能有效阻止病情进展，增加患儿获救的机会。

关键词: 坏死性筋膜炎, 预后, 新生儿

Abstract:

Objective: To report the diagnosis and treatment of one neonate with acute necrotizing fasciitis（NF）and explore its
clinical characteristics and key points for treatment with literature review. Methods: Based on the clinical files of this case, the
databases about neonatal acute NF were collected prior to 10th January 2019 from PubMed, METSTR, CNKI, WANFANG and then
literature reviewed. A systematic review of neotatal acute NF was presented. Results: The neonate with scrotal acute NF was cured
successfully by surgery, antibody and antishock therapies and recovered uneventfully with a 9-day hospital stay. A total of 159 articles
in Chinese and English with neonatal NF were retrieved but 184 neonate cases were reported update in 53 articles after excluding the
reviews and cases repeated calculation. There were 93 boys and 91 girls among the 184 cases and 3.5 cases per article in average, but
in only 16 cases the lesion occurred in the perineum including scrotum. After treatment, 115 cases survived with a cure rate of 62.5%
and 69 cases died with a mortality rate of 37.5%. Among the dead, 58 cases died after operation with a postoperative mortality of 33.5%
and the other 11 cases died with conservative treatment. Conclusion: Neonatal NF develops rapidly and is with dangerous prognosis
and high mortality. Prevention and correction of internal environment disorders and anti-infective therapy should be done as soon as
diagnosed and disease progress could be prevented effectively through lesion incision widely and drainage or necrotic tissue clearance
earlier to increase the chances for survival.

Key words: necrotizing fasciitis, prognosis, neonate

中图分类号:

R726

何杰, 张杉杉, 申伟, 李娜, 刘青铃, 王宁, 吴学东. 成功救治新生儿急性阴囊坏死性筋膜炎1例并文献复习[J]. , 2019, 4(8): 16-22.

HE Jie, ZHANG Sha-Sha, SHEN Wei, LI Na, LIU Jing-Ling, WANG Ning, TUN Hua-Dong. The Management of Neonatal Acute Scrotal Necrotizing Fasciitis in a Case and Literature Review[J]. , 2019, 4(8): 16-22.

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