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女子扁桃体发炎多日 脖子上的肉被“吃”掉一大片

2017-09-07 10:57:10   中国青年网

“一了解病人的情况,我们首先想到了可怕的坏死性筋膜炎这个毛病,所幸终于把它‘制服’了。”浙江省人民医院耳鼻喉科主任苏立众感叹道。近日,该院救治了一例十分少见、凶险的坏死性筋膜炎(又称“食肉菌”感染),耳鼻喉科在感染病科等学科协助下,终于使患者转危为安。

如此凶险的“扁桃体炎”很少见

“扁桃体炎怎会如此凶险?”半个多月前的深夜11点多,浙江省人民医院耳鼻喉科值班医生王强刚闲下来,值班手机急促地响起来,“有危重病人送来!”很快,一名中年女性在家人陪同下来到王强面前。

患者姓马,今年40岁,来自安徽,主要是颈胸部脓肿引起的咽部疼痛。马女士有气无力地告诉王医生,前段时间,以为是疲劳感冒后引起的急性扁桃体炎导致的咽痛,当时没有引起重视。

熬了两天,症状逐渐加重,遂在当地社区医院静脉滴头孢类抗生素。没想到,用药后症状非但未减轻,反而越来越加重,出现了反复发热、头痛、乏力、咽痛加剧,不敢做吞咽的动作,后来连耳朵都出现剧痛,颈部皮肤红肿痛得不能触摸等严重不适,此时马女士及家人隐约觉得病情没那么简单。

社区技术有限,马女士随即去了当地一家市级医院就诊。谁料想,医院详细了解病情后,认为病情严重,建议立即转院。往哪儿转?正巧有亲戚在杭州工作,商量后决定去杭州治疗。

事不宜迟,患者与家人立即包了一俩车,驱车几小时到达杭州,随后接近零点赶到浙江省人民医院。

王强回忆说,马女士来院时已出现了呼吸困难,反复高热,发声、张口、吞咽困难等严重的临床症状。

王强连夜进行喉镜检查等,发现患者口咽部大量脓性分泌物,右侧咽侧壁肿胀;颈部急诊CT提示右侧颈胸部可见多发脓腔,患者当晚办理了住院,随即医生就下了病危通知书,告知患者可能出现生命危险。同时通过医生积极用药对症处理,夜间病情稍有好转。

头颈部CT显示,肉被“吃空了” 遇到“劲敌” 一场生死拉锯战

凶险的病情,引起专家们的充分重视。天亮,马女士入院后第一天下午,科主任、主任医师苏立众就主持全科室医生对她这个病情进行讨论,科室意见是先行气管切开术然后再用足量抗生素处理,随后请感染科会诊调整抗生素。

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