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梭状芽胞杆菌性肌坏死

Authors
Dennis L Stevens, MD, PhD
Amy Bryant, PhD
Section Editor
John G Bartlett, MD
Deputy Editor
Elinor L Baron, MD, DTMH
Translators
钱红波, 副主任医师，副教授

引言

梭状芽胞杆菌性肌坏死(气性坏疽)是一种危及生命的肌肉感染，可从创伤部位连续性发展，或可从胃肠道通过血行播散传播到肌肉。早期发现和积极治疗至关重要。

梭状芽胞杆菌所致的气性坏疽有创伤性和自发性两种。创伤性气性坏疽最常见的原因是产气荚膜梭菌(Clostridium perfringens)，自发性坏疽最常见的原因为败毒梭菌(C. septicum)。

本专题将讨论梭菌属细菌引起的坏死性肌肉感染相关问题。链球菌引起的坏死性肌炎以及累及皮肤和筋膜的感染将单独讨论。 (参见“坏死性软组织感染”)

梭状芽胞杆菌感染类型

梭菌属细菌能够产生芽胞，因此能在自然界中广泛存在。它们常见于土壤和海洋沉积物，也常见于人类和动物的胃肠道内。梭状芽胞杆菌所致软组织感染的类型包括：伤口污染、厌氧菌所致蜂窝织炎、肌肉坏死(气性坏疽)和坏死性筋膜炎[1]。

●伤口可能被含有梭菌属芽胞或生长态梭菌属的泥土所污染，但未失活的组织被梭菌属细菌污染并不一定会发生感染。例如，在一项研究中有30%-80%的开放性创伤伤口被梭菌属细菌污染[2]。

                

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Literature review current through: 2017-06 . | This topic last updated: 2016-05-12.
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References
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