台大医院外科加护病房专科护理师
案例分析报告
2002.11.4
报告者 : 纪慧莹
指导者 : 陈淑卿
柯文哲
坏死性筋膜炎(Necrotizing fasciitis)病患之加护病房照护经验分享
姓名:翁 凤 女士
病历号:4209616
年龄 : 56
床号 : 4C1-01
Past History :
DM under medical control .

Brief History
She had sore throat with fever since 2 weeks ago. Thus, she went to 亚东医院 for help and acute tonsillitis was impressed. Conservative treatment was given then.
However, sympotm was not relief. Neck Mass progressing to right face, fever and chillness .She was transfered to our hospital for help.
Course and Management
91/9/10 9AM in NTUH ER
Consult ENT
Arrange Neck / Chest CT
Severe deep neck infection from submandibular gland to parapharyngeal space and necrotizing fasciitis was extend to anterior chest wall and back .
The patient was performed emergent operation ( I and D for pus drainage and
tracheostomy .)
Neck / Chest CT
Neck / Chest CT
Neck / Chest CT
Neck / Chest CT
ENT Incision and Debridment
Tracheostomy
Course and Management
91/9/11 at SICU
1.Massive tarry stool >1500ml+ NG
coffee ground Bloody
2.Wound persistent oozing.
3.Still crepitus over bilateral upper
chest wall. Extent of abscess .
Further debridement is indicated.
4.High mortality rate !
Course and Management
Arrange PES for UGI Bleeding is need intervention .(Active bleeding from Duodenum bulb and local injection of Bosmin followed by hemoclipping was performed but in vain.)

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