背景:产褥期败血症是一种由感染引起的危及生命的疾病,可迅速发展为多系统感染和毒素介导的休克。对称的外周坏疽被定义为在没有主要血管闭塞性疾病的两个或多个部位的对称的远端缺血性损伤。这种综合症是毁灭性的和罕见的。在这项研究中,我们介绍一例产褥期败血症并发对称性周围坏疽。
方法:一名23岁妇女在妊娠39周时,在宫颈球囊扩张后阴道分娩了一名活的女婴。持续的高热在产后第一天发展。在经历了心室纤颤之后,急性肝功能衰竭,急性肺水肿,她在产后第5天四肢变黑。
方法:产褥期败血症并发对称性周围坏疽。
方法:转院后,患者被纳入重症监护病房,接受了抗感染和截肢手术.
结果:手术后,病人恢复良好,并成功出院。
结论:早期发现和及时治疗是降低产褥期脓毒症病死率和后遗症的最佳方法。当脓毒症患者出现肝功能损害时,医生应警惕合并对称外周坏疽的可能性。
BACKGROUND: Puerperal sepsis is a life-threatening condition caused by infection that can rapidly progress to multisystem infection and toxin-mediated shock. Symmetrical peripheral gangrene is defined as symmetrical distal ischemic damage in two or more sites in the absence of major vascular occlusive disease. The syndrome is devastating and rare. In this study, we introduce a
case of puerperal septicemia complicated by symmetrical peripheral gangrene.
METHODS: A 23-year-old woman delivered a live female infant vaginally after cervical balloon dilatation at 39 weeks of gestation. Persistent hyperthermia developed on the first postpartum day. After experiencing ventricular fibrillation, acute liver failure, and acute pulmonary edema, she developed blackened
extremities on the 5th postpartum day.
METHODS: Puerperal septicemia complicated by symmetrical peripheral gangrene.
METHODS: Upon transfer to our hospital, the patient was enrolled in the intensive care unit and underwent anti-infective and amputation surgery.
RESULTS: After the surgery, the patient recovered well and was successfully discharged from the hospital.
CONCLUSIONS: Early detection and timely treatment is the best way to reduce the mortality and sequelae of puerperal sepsis. Physicians should be alert to the possibility of comorbid symmetrical peripheral gangrene when sepsis patients present with hepatic impairment.