muscle necrosis
Introduction
Introduction Muscle necrosis refers to the condition that the muscle is over-squeezed by external force or affected by other factors, causing the muscle to lose the ability to absorb nutrients, resulting in muscle infection, decay, and eventually necrosis. Generally manifested as a series of inflammatory reactions such as pain, swelling, redness and fever in muscle necrosis. There may also be dysfunctions.
Cause
Cause
The pathogen of anaerobic streptococcal myositis is digestive streptococci, which is widely found in nature and is one of the normal flora of the human oral, intestinal and genitourinary tract, and is therefore a conditional pathogen. It has 9 species. Among the important surgical infections are P. anerobius, P. micros, P. asaccharolyticus and large digestive chains. P. magnus. They often form mixed infections with aerobic bacteria (such as group B streptococci, enterobacteria, staphylococcus, etc.) or other anaerobic bacteria (such as Bacteroides). Its pathogens are mainly strong exotoxins and a series of highly active enzymes. Heavily polluted trauma and surgery are the most common predisposing factors, and local muscle ischemia and hypoxia are also likely to induce this disease. Anaerobic streptococcal myositis can also spread from infections in adjacent tissues and organs. For example, the spread of periodontal suppurative infection can lead to necrosis of facial and neck muscles. Patients with digestive streptomyositis often have systemic diseases that cause low immune function, such as diabetes, malignant tumors, chronic renal failure, chemotherapy, immunosuppressive agents, malnutrition, and the like. Some patients have no cause of morbidity and are called idiopathic cases.
Examine
an examination
Related inspection
Electromyography, mammography, X-ray examination of the bones and joints of the extremities
Laboratory inspection:
1. Peripheral blood.
(1) White blood cell count: white blood cell count increased with nuclear left shift.
(2) Red blood cell count and hemoglobin: there may be a decrease in red blood cells and a decrease in hemoglobin.
2. Bacteriological examination.
(1) Smear of secretion: stained with smear of lesion secretion, microscopic examination of a large number of Gram-positive cocci, contributing to the preliminary pathogenic diagnosis.
(2) Fluorescence method and enzyme dyeing method detection: It has the advantages of fast, simple, sensitive and specific, and can detect mixed anaerobic bacteria to make mixed antibodies to expand the detection range.
Other auxiliary inspections:
1.X-ray film
Gas formation in the muscle is sometimes seen.
2.CT
Shows muscle swelling and air bubbles.
Diagnosis
Differential diagnosis
Muscle bruises: Muscles are hit by foreign objects, causing pain, congestion, redness, dysfunction, muscle spasms, deformities and other symptoms. Clinical manifestations include pain, congestion, redness, dysfunction, muscle spasms, deformities, and the like.
Muscle tenderness is a clinical manifestation of polymyositis. Polymyositis is a group of patients with unclear etiology. The main clinical manifestations are diffuse muscle inflammatory diseases characterized by symmetric proximal extremities, cervical muscles, pharyngeal muscle weakness, muscle tenderness, and increased serum enzymes.
Muscle strain is a damage caused by a sharp contraction or excessive pulling of muscles during exercise. This is easy to occur during long, pull-ups and sit-up exercises. After the muscle strain, the painful part of the strained area can be touched by the muscles of the muscles, and the pain is obvious. The local swelling or subcutaneous hemorrhage is obviously restricted.
Muscle contusion: A non-open injury that occurs when a blunt object acts directly on the soft tissue of the carcass. Clinical symptoms vary widely. Mild contusion is usually a capillary hemorrhage, and the lymphatic fluid that flows out of the capillary lymphatics accumulates between the muscle and the connective tissue, causing swelling and pain. Severe contusion can cause hematoma or even shock. Different contusions can cause different dysfunctions. For example, joint contusion can cause obvious pain during exercise. Thoracic wall contusion can cause hemothorax or even fracture, complicated with shock and cardiopulmonary dysfunction. Muscle bleeding occurs because it is pulled too much or is directly hit, causing muscle fiber to tear and causing bleeding. Bleeding is the main clinical manifestation of this disease. Patients have spontaneous/slight injury/long-term bleeding tendency after surgery. Heavy-duration can occur both after birth and milder. Muscle soreness is a very common injury experience for those involved in sports. In general, exercise-induced muscle soreness can be divided into acute muscle soreness and chronic (late onset muscle soreness). Acute muscle soreness is different from muscle strain, but refers to the soreness caused by temporary ischemia of the muscles. It only occurs when the muscles are intense or long-term, and the muscle activity disappears as soon as the muscle activity ends. Usually, acute muscle soreness can be mixed with muscle stiffness.
Muscle atrophy refers to the reduction of muscle volume caused by dystrophic dystrophy, muscle fiber thinning or even disappearance. Muscle atrophy is often accompanied by low muscle strength, so you should pay attention to the comparison of muscle volume and muscle strength, pay attention to muscle strength and muscle tension in muscle atrophy. The inspection should be carried out in a warm environment and in a comfortable position. Patients should be allowed to relax as much as possible. It can be judged by touching the hardness of the muscle and the resistance that is felt when the patient's limb is flexibly flexed. When the muscle tension is reduced, the muscles are slack, the resistance is reduced or disappeared during passive exercise, and the range of motion of the joint is enlarged. More common in lower motor neuron lesions, some myopathy such as disuse muscle atrophy.
diagnosis:
1. History of trauma: Diagnosis is based on medical history, clinical manifestations and combined with pathogen examination.
2. Clinical manifestations: improved wound swelling, severe pain, and plasma-like fluid exudation with malodor.
3. Pathogen examination: A large number of Gram-positive cocci are visible in the secretion smear.
