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目的归纳总结1例创伤弧菌创面感染后继发感染性休克的临床特征和诊治方法,为临床治疗创伤弧菌感染提供经验。方法回顾性分析于2016年9月-10月诊治的1例创伤弧菌创面感染后继发感染性休克的症状、体征、体温变化及实验室检查结果和诊治过程;采集该患者的静脉血和创面进行培养,VITEK 2 Compact对培养的细菌进行鉴定和药敏试验。结果创面培养和血培养的细菌均是创伤弧菌,根据药敏结果选择敏感抗菌药物加上外科手术治疗后患者体温、肝肾功能、降钙素原等指标恢复正常。结论创伤弧菌能穿过破损的皮肤感染人类,引起伤口感染和血流感染,早期的创面培养和血培养是必须的。尽早行外科手术加抗感染治疗是创伤弧菌感染后治疗的关键,防止继发感染性休克危及到患者生命。
Objective To summarize the clinical features and diagnosis and treatment of septic shock caused by Vibrio vulnificus infection in 1 case and provide experience for clinical treatment of Vibrio vulnificus infection. Methods A retrospective analysis of the symptoms, signs, changes in body temperature, laboratory findings and diagnosis and treatment of a septic shock caused by Vibrio vulnificus infection during September to October 2016 was performed. Venous blood and wounds of the patients were collected Culture, VITEK 2 Compact on the identification of bacteria and drug susceptibility testing. Results The wound cultures and blood cultures were all Vibrio vulnificus. The sensitive antimicrobial agents were selected according to the susceptibility results and the body temperature, liver and kidney function and procalcitonin were returned to normal after surgical treatment. Conclusion Vibrio vulnificus can infect humans through damaged skin, causing wound infection and bloodstream infection. Early wound culture and blood culture are necessary. Surgery as soon as possible anti-infective therapy is the key to the treatment of Vibrio vulnificus infection, to prevent secondary septic shock endanger the lives of patients.