颈部坏死性筋膜炎的诊断和治疗(附二例报告)

结合文献复习，探讨坏死性筋膜炎（necrotizing fasciitis,NF）的病因、临床表现及诊治。早期给予大剂量强力广谱抗生素；及时脓肿切开，彻底清创引流，切除全部坏死组织直至可见到出血红润的正常组织，创面用3％双氧水、抗生素液冲洗后放置引流；术后加强换药，伤口Ⅱ期缝合；可选择使用高压氧辅助治疗。治疗过程中注意观察处理原发感染病灶及并发症。结果2例均治愈，伤口延期愈合。分析认为，及早诊断、尽量抗生素和有效的外科处理以及防治并发症是治疗抢救成功的关键。

Diagnosis and treatment of cervical necrotizing fasciitis: A report of 2 cases

To explore the causes,clinical manifestations and treatment of necrotizing fasciitis (NF) and to review the literatures. Large dosage and effective broad spectrum antibiotics were given at the early stage.The abscess was incised in time and drained thoroughly.All the necrotic tissue was cut until the fresh normal tissue appeared.Drainage tubes was set in the wound after the wound were irrigated with 3% hydrogen peroxide and antiseptic solution.The times of dressing change must be enough after operation and the wound was sutured.The supplementary therapy of hyperbaric oxygen may be selected to use.The primary infective focus and complications were observed and treated during the therapeutic course.Both cases were cured,but the wound healing were delayed. The keys of successful treatment were the early diagnosis,and in time full dosage treatment of antibiotic,the effective surgical interference should be performed and the complication prevented and cured.