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肛周坏死性筋膜炎临床诊治中国专家共识(2019年版)

Chinese expert consensus on diagnosis and treatment of perianal necrotizing fasciitis (2019)
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摘要 肛周坏死性筋膜炎是一种发生于肛周、会阴部的严重软组织感染性疾病,多种细菌协调作用(包括需氧菌和厌氧菌)造成皮肤及软组织化脓性坏死。本病进展迅速,可经血液循环引起全身脓毒血症,常并发休克、多器官功能衰竭(MODS)甚至死亡。对早期感染诊断和治疗的延误,可能导致更高的病死率。由于我国目前缺乏统一规范的诊治流程,故中国医师协会肛肠医师分会临床指南工作委员会组织国内专家,通过借鉴国外最新指南及文献,结合我国的研究成果及临床实践,针对肛周坏死性筋膜炎的病因病理、临床表现、实验室及影像学检查、术前准备、治疗(抗生素的应用、清创的时机及要点、辅助手术)、术后伤口管理、营养支持治疗、外科重建、康复等多方面相关问题,进行了多次讨论,最终于2019年4月形成了专家共识。 Perianal necrotizing fasciitis is a serious soft tissue infectious disease of perianal and perineal regions,where a synergistic action of multiple bacteria (including aerobic bacteria and anaerobic bacteria) results in suppurative necrosis of the skin and soft tissue. The disease progress may rapidly cause systemic sepsis through blood circulation,often with complicating shock and MODS,or death. Any delay in diagnosis and treatment of early acute infections may lead to higher mortality because of lack of standardized treatment. The Clinical Guidelines Committee aims to formulate expert consensus on the treatment of perianal necrotizing fasciitis in terms of etiology and pathology,clinical manifestations,laboratory and imaging study,preoperative preparation,surgical treatment (the application of antibiotics,the timing and key points of debridement,assistant therapy),postoperative wound care,nutritional support,surgical reconstruction and rehabilitation. This consensus is a reference for clinicians based on patient conditions.
作者 魏东 无(Clinical Guidelines Committee,Colorectal Surgeons Branch of Chinese Medical Doctor Association)
出处 《中华胃肠外科杂志》 CAS CSCD 北大核心 2019年第7期689-693,共5页 Chinese Journal of Gastrointestinal Surgery
关键词 坏死性筋膜炎 肛周 诊断 治疗 专家共识 Necrotizing fasciitis,perianal Diagnosis Treatment Consensus
作者简介 通信作者:魏东,Email:wd150yyw5k@yeah.net,电话:0379-64169319.
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