59例偶发分支杆菌皮肤感染的外科处理  

Surgical management of skin infection with mycobacterium fortuitum:a report of 59 cases

作　　者：黄金生[1] 陈平[1] 向高[1] 陈德永[1] 魏明和[2] 

机构地区：[1]福建省南平市第一医院外科,福建南平353000 [2]福建省南平市延平区樟湖镇卫生院外科,福建南平353000

出　　处：《中国普通外科杂志》2002年第12期731-733,共3页China Journal of General Surgery

摘　　要：目的　探讨皮肤软组织偶发分支杆菌感染的外科处理时机 ,指征和术式。方法　通过细菌学、组织病理、B超和临床观察 ,对 59例 76处病灶不同外科处理方法的效果作一回顾性分析。结果　45例 (52处病灶 )手术切除 ,其中除 8处创口有反复外 ,其余均一期愈合 ;扩创或切开引流 6例 ,5例愈合 ,1例新发病灶二次扩创清除后愈合 ;8例抽脓后注入阿米卡星 (AMK)未行切除 ,病灶均消失。 59例经综合治疗后全部治愈。结论　在全身给药有效治疗 6～ 8周后 ,局部病变得到控制 ,肉芽肿形成时为手术的最佳时机。术式以距病灶周边 1 .5～ 2 .0cm处完整切除为宜。Objective To determine the optimal time,indication and type of surgical management for the skin infection with mycobcterium fortuitum. Methods The treatment effects of different surgical management for this disorder were retrospectively compared and analyzed. Results Fifty two focal lesions(FLs) were surgically removed in 45 cases. Phase I healing was obtained in all FLs except recurrence in 8 FLs. Incision and draining or curettage were performed in 6 cases, of which 5 were cured,and the other new focal lesion formation was found and cured by secondary currettage.AMK was locally applied in 8 cases after extraction of abscess without removal of the lesion,and all the 8 cases were cured.All the 59 cases were cured after combination treatment. Conclusions The optimal time for local surgical treatment of skin Mf infection is when the focal lesion has been well controlled and granulation formed after 6～8 weeks of systemic treatment.The removal of focal lesion should be done,the resection margin of the skin should be 1.5～2cm far away the lesion.

关 键 词：偶发分支杆菌 皮肤感染 外科手术 治疗 手术方式 

分 类 号：R632[医药卫生—外科学] R378.99[医药卫生—临床医学]