1例2型糖尿病合并臀部急性坏死性筋膜炎患者诊疗思考

Diagnosis and Treatment of a Case of Type 2 Diabetes Complicated with Acute Necrotizing Fasciitis of Buttocks

摘要: 目的：探讨1例2型糖尿病合并臀部急性坏死性筋膜炎患者的诊疗过程，为今后此类患者的诊治提供参考。方法：此例患者经普通外科、内分泌科、麻醉科多学科协同配合，在行臀部急性坏死性筋膜炎清创引流术后接受伤口换药、血糖调节、感染控制等处理，处理过程中采用了以伤口评估三角联合RYB创面评估法为主的伤口评估方法、短效胰岛素加甘精胰岛素联合胰岛素泵短期强化治疗的血糖调节方法以及在伤口换药过程中低浓度碘伏浸泡等方法。结果：该患者经过近2个月综合治疗最终达到伤口愈合。

Abstract: Objective: To explore the diagnosis and treatment process of a case of type 2 diabetes with acute necrotizing fasciitis of buttocks, and provide reference for the diagnosis and treatment of such patients in the future. Method: In this case, the patient underwent a multidisciplinary collaboration of general surgery, endocrinology, and anesthesia. After undergoing debridement and drainage surgery for acute necrotizing fasciitis of the buttocks, the patient received wound dressing change, blood glucose regulation, infection control, and other treatments. During the treatment process, the wound evaluation method mainly used the triangle of wound evaluation combined with RYB wound surface evaluation method, the blood glucose regulation method of short-term intensive treatment with short insulin plus glargine insulin combined with insulin pump, and the low concentration iodine immersion method during wound dressing change were adopted. Result: After nearly 2 months of comprehensive treatment, the patient finally achieved wound healing.