产气荚膜梭菌感染致足气性坏疽1例报告并文献分析  

Foot gas gangrene infected by Clostridium perfringens and literature analysis

作　　者：李晓哲[1] 张玉芹[2] 石翠明 李钊[3] 史华芳 刘利华[1] Li Xiaozhe;Zhang Yuqin;Shi Cuiming;Li Zhao;Shi Huafang;Liu Lihua(Clinical Laboratory,Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China;Department of Laboratory and Blood Transfusion,Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China;Department of Respiration No.1,Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China;Department of Hand and Foot Surgery,Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China)

机构地区：[1]济宁医学院附属医院检验科,山东济宁272000 [2]济宁医学院附属医院检验输血科,山东济宁272000 [3]济宁医学院附属医院呼吸一科,山东济宁272000 [4]济宁医学院附属医院手足外科,山东济宁272000

出　　处：《实用检验医师杂志》2021年第2期120-122,共3页Chinese Journal of Clinical Pathologist

基　　金：山东省济宁市科技发展计划项目(2016-56-39)。

摘　　要：目的报告1例产气荚膜梭菌感染足气性坏疽患者的诊疗过程。方法2018年6月8日济宁医学院附属医院手足外科收治1例外伤深部创伤合并感染患者;采用微生物检验与临床诊断相结合的方法,彻底清创的同时送检微生物需氧和厌氧菌培养。结果患者为77岁男性,因“左足扎伤后流脓、发臭1 d”入院。无菌操作采集脓性分泌物送检并进行厌氧菌培养;镜检鉴定结果显示,油镜下可见产气荚膜梭菌;采用全自动微生物鉴定仪进行细菌鉴定,结果为产气荚膜梭菌(鉴定编码:0407545232522)。该患者诊断为足气性坏疽,经及时清创联合抗感染、给予氧气、持续负压引流冲洗等治疗后,患者于7月7日好转出院。结论由产气荚膜梭菌引起的足气性坏疽发病急、进展快,来势凶猛,本例患者及时进行病原菌培养,为临床提供了可靠的治疗依据,大大降低了风险。Objective To report a case of foot gas gangrene infected by Clostridium perfringens.Methods On June 8,2018,a case of deep trauma complicated with infection was admitted in department of hand and foot surgery of Affiliated Hospital of Jining Medical College.Microbiological test and clinical diagnosis were combined,and after thorough debridement,aerobic and anaerobic cultures of microorganisms were performed for examination.Results The patient,a 77-year-old male,was admitted to the hospital for"1 day of purulence and odor after stabbing the left foot".The purulent secretion was collected by aseptic operation and sent for anaerobic culture;the microscopic identification results showed that Clostridium perfringens could be seen under oil microscope;the bacteria was identified by automatic microbial identification instrument,and Clostridium perfringens was identified(identification code:0407545232522).The patient was diagnosed as foot gas gangrene.After timely debridement combined with anti-infection,oxygen and continuous negative pressure drainage treatment,the patient was improved and discharged on July 7.Conclusion Foot gas gangrene caused by Clostridium spp.has an acute onset,with rapid progress and fierce attack.In this case,the pathogen culture was carried out in time,which provided an effective basis for clinical treatment and greatly reduced the risk.

关 键 词：气性坏疽 产气荚膜梭菌 文献分析 

分 类 号：R633.2[医药卫生—外科学]