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中华损伤与修复杂志(电子版) ›› 2023, Vol. 18 ›› Issue (05) : 394 -398. doi: 10.3877/cma.j.issn.1673-9450.2023.05.006

论著

虎门地区创伤弧菌感染的临床观察
廖锵云, 王震(), 林洁玉, 廖夏, 邓锦华, 李杰峰, 邓建维, 李明, 荣新洲   
  1. 523905 东莞市滨海湾中心医院烧伤整形和手足外科
    510180 华南理工大学附属第二医院 广州市第一人民医院烧伤整形美容与创面修复科
  • 收稿日期:2023-05-10 出版日期:2023-10-01
  • 通信作者: 王震

Clinical observation on vibrio vulnificus infection in Humen area

Qiangyun Liao, Zhen Wang(), Jieyu Lin, Xia Liao, Jinhua Deng, Jiefeng Li, Jianwei Deng, Ming Li, Xinzhou Rong   

  1. Burn Plastic & Hand and Foot Surgery, Dongguan Binhai Bay Central Hospital, Dongguan 523905, China
    Department of Burns Plastic & Cosmetology and Wound Repair Surgery, the Second Hospital of South China University of Technology, Guangzhou First People′s Hospital, Guangzhou 510180, China
  • Received:2023-05-10 Published:2023-10-01
  • Corresponding author: Zhen Wang
引用本文:

廖锵云, 王震, 林洁玉, 廖夏, 邓锦华, 李杰峰, 邓建维, 李明, 荣新洲. 虎门地区创伤弧菌感染的临床观察[J/OL]. 中华损伤与修复杂志(电子版), 2023, 18(05): 394-398.

Qiangyun Liao, Zhen Wang, Jieyu Lin, Xia Liao, Jinhua Deng, Jiefeng Li, Jianwei Deng, Ming Li, Xinzhou Rong. Clinical observation on vibrio vulnificus infection in Humen area[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(05): 394-398.

目的

观察东莞市虎门地区19例创伤弧菌感染的临床特点。

方法

回顾性分析东莞市滨海湾中心医院烧伤整形和手足外科2018年1月至2023年1月收治的创伤弧菌感染患者19例临床资料,观察其临床特点并总结救治经验和教训。

结果

19例创伤弧菌感染多发生于夏秋两季(13/19,68.42%)。患代谢性疾病或肝功能异常者易感(11/19,57.89%),死亡3例均为痛风患者。19例患者中18例为入院当天创伤弧菌培养阳性(抗生素应用前),1例为入院第2天创伤弧菌培养阳性,之后细菌培养均未发现创伤弧菌。白细胞数量与中性粒细胞百分比、降钙素原具有相关性(r=0.972,P=0.000;r=0.861,P=0.006),白细胞水平随病情改善呈逐步下降趋势。

结论

虎门地区创伤弧菌感染多发生于夏秋两季,患代谢性疾病者易感,痛风患者预后差,对多数抗生素敏感。白细胞和降钙素原是反映病情及转归的良好指标。

Objective

To explore the clinical characteristics of 19 cases of Vibrio vulnificus infection in Humen area.

Methods

The clinical data of 19 patients with Vibrio vulnificus infection admitted to Burn Plastic & Hand and Foot Surgery, Dongguan Binhai Bay Central Hospital from January 2018 to January 2023 were retrospectively analysed, observed the clinical characteristics and summarized the experience and lessons of treatment.

Results

Vibrio vulnificus infection mostly occured in summer and autumn (13/19, 68.42%). The patients with metabolic disease or abnormal liver function were susceptible (11/19, 57.89%), and the prognosis of gout patients was relatively worse, the three deaths were all gout patients. There were 18 positive cases in bacterial culture of Vibrio vulnificus before the application of antibiotics on the day of admission, one positive case was found one day later. Afterwards, no Vibrio vulnificus was found in bacterial culture. The number of white blood cells were closely related to the percentage of neutrophils and the level of procalcitonin (r=0.972, P=0.000; r=0.861, P=0.006). The white blood cell levels gradually decreased along with the condition improved.

Conclusion

The infection of Vibrio vulnificus in Humen area mostly occurs in summer and autumn. Patients with metabolic diseases are more susceptible, and gout patients have a poor prognosis. Vibrio vulnificus is sensitive to most antibiotics. The white blood cell and procalcitonin are good indicators for the severity and prognosis.

表1 创伤弧菌感染患者临床资料
图1 创伤弧菌感染患者白细胞数量、中性粒细胞百分比及降钙素原变化情况。A示患者白细胞数量变化;B示患者中性粒细胞百分比变化;C示患者降钙素原变化。其中死亡3例,自动出院1例,数据不全2例,纳入13例
图2 左上肢动物咬伤创伤弧菌严重感染截肢后二期植皮修复。A示入院时患肢肿胀,肢端缺血;B示左上肢切开减张、排脓清创;C示左上肢截肢后局部仍残留部分坏死组织;D示截肢残端移植皮片成活;E示左上肢残端伤口愈合
图3 右上肢不明原因创伤弧菌感染切开清创后二期植皮修复。A示入院时右手及右前臂肿胀,张力性水泡形成;B示右手背及右前臂切开减张、排脓清创;C示创面部分缝合联合皮片移植;D示移植皮片成活,创面愈合
图4 右上肢福寿鱼刺伤创伤弧菌感染切开减张后二期缝合修复。A示右手及前臂肿胀并形成张力性水泡;B示右手背及前臂切开减张并扩创;C示缝合创面;D示拆除缝线,伤口愈合
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