严重多发伤合并颌面部坏死性筋膜炎3例

目的：探讨严重多发伤后合并颌面部坏死性筋膜炎的临床特征及治疗方法。方法：回顾近10年诊治的严重多发伤后合并颌面部坏死性筋膜炎3例临床资料，结合文献复习，讨论其发病原因、临床表现和诊治方法。结果：2例获得良好疗效，1例病例死亡。结论：对严重多发伤后合并颌面部的坏死性筋膜炎应引起足够重视，及时有效地外科处理，联合应用抗生素和防治并发症是治疗成功的关键；颌面部皮肤缺损创面，要适时用皮片移植修复。

Three cases of maxillofacial necrotizing fasciitis caused by severe multiple trauma

Objective:The purpose of this study is to analyse the clinical features of maxillofacial necrotizing fasciitis and the countermeasuer against it.Method:We report three cases of maxillofacial necrotizing fasciitis that occurred as a result of severe multiple trauma. Three cases had treated in our department from 1993 to 2003. The clinical data of the 3 patients was retrospectively analysis, with emphasis on the cause, clinical manifestation , diagnosis and treatment. Relevant literatures were reviewed. Result:The 3 patients with maxillofacial necrotizing fasiitis underwent extensive debridement. Two cases gained good clinical recovery. One case associated with diabetes died with many organs failure.Conclusion:Necrotizing fasiitis is still a rare but potentially fatal disease. More attention should be paid to this disease in clinical practice. A successful non-fatal outcome was achieved following early presentation and diagnosis, supportive measures, broad-spectrum antibiotics therapy, prevention and control of the systemic and associable disease. Prompt and aggressive surgical debridements remains the cornerstone of management, so does the intensive supportive care to the patients.The antibiotic regimen should be modified on the basis of culture and sensitivity. Principles of maxillofacial wound management include routine diversion, injury repair with free split-thickness skin grafting.