多次扩创 负压吸引治疗软组织社区获得性MRSA感染

作者单位:1.450046 郑州,河南中医药大学;2.450002 郑州,河南省中医院

 MRSA;社区获得性MRSA感染;软组织;负压吸引

Treatment of Community-acquired MRSA Infection in Soft Tissue by Multiple Debridement and Invasive Vacuum Suction
ZHANG Yanping1 , HAN Yeping1 , AI Jinwei2 , LI Guanghui2 DU Chenfei2

(1.Henan University of Traditional Chinese Medicine, Zhengzhou 450046, Henan Province, China; 2.Henan Traditional Chinese Medicine Hospital)

 MRSA; Community Acquired MRSA Infection; Flab; Vacuum Suction

DOI: 10.3969/j.issn.1672-7185.2019.09.030

备注

 目的  分析多次扩创、负压吸引及敏感抗生素的联合应用治疗软组织社区获得性耐甲氧西林金黄色葡萄球菌( M R S A)感染的临床疗效。方法  回顾性分析2017年1月—2018年6月,河南省中医院收治的20例软组织社区获得性M R SA感染患者的临床资料,对临床治疗、细菌培养结果及抗生素使用情况进行分析总结。结果  12例感染范围局限病例,选用较低级别的敏感抗生素;8例感染范围较大者,选用万古霉素。所有患者创面均在3~4周内愈合,创面瘢痕不严重,肢体功能恢复良好。随访均超过半年,无复发病例。结论  对于感染范围局限,感染程度较轻的软组织社区获得性M R SA感染者,在彻底扩创、负压吸引基础上,可以选择较低级别抗生素;但对于感染范围较大、感染程度严重者,首选万古霉素。
Objective To explore the clinical efficacy of multiple debridement, vacuum suction and sensitive antibiotics in the treatment of community-acquired MRSA infection in soft tissue. Methods  The clinical data of 20 patients with community-acquired MRSA infection in soft tissues, whcih were collected from Henan traditional Chinese medicine hospital during the periods of January 2017 to June 2018. were retrospectively analyzed. The clinical treatment, bacterial culture results, and antibiotic usage were analyzed and summarized. Results  Among the 12 cases with limited infection range, lower sensitive antibiotics were selected, and 8 cases with larger infection range selected vancomycin. All the patients healed within 3 ~ 4 weeks, the wound scar was not serious, and the limb function recovered well. All the patients were followed up for more than half a year, and there were no recurrence cases. Conclusion  For patients with mild soft tissue community acquired MRSA, low sensitive antibiotics can be selected on the basis of multiple debridement, vacuum suction, but vancomycin is the first choice for severe infection.