中毒性表皮坏死松解症的治疗:静脉滴注免疫球蛋白治疗9例患者的经验(德语)  

Treatment of toxic epidermal necrolyis. Experience with 9 patients with consideration of intravenous immunoglobulin (Germ)

作　　者：Spornraft-Ragaller P. Theilen H. Gottschlich G. Ragaller M. 周少娜 

机构地区：[1]Klinik und Poliklinik für Dermatologie, Universittsklinikum Carl Gustav Carus, Technischen Universitt Dresden, Fetscherstraβe 74, 01307 Dresden Dr.

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第6期51-51,共1页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Toxic epidermal necrolysis (TEN) is the maximal variant of severe bullous drug reactions with a high mortality rate of 30-40%. Treatment should be interdisciplinary and is best provided in an intensive care setting. Since no specific therapy has been established, supportive intensive care and topical treatment are of crucial importance. Between 1995 and 2005, nine patients with TEN were treated in the anesthesiology intensive care unit in cooperation with dermatology in the University Hospital of Dresden. All patients initially received corticosteroids and five patients were additionally treated with intravenous immunoglobulins (IVIG). The overall mortality of 33%was underestimated by the SAPS II-Score, whereas it was overestimated by the TEN-specific SCORTEN. In more severely affected patients, other scoring systems in addition to SCORTEN should be used for prediction of prognosis and evaluation of therapy. The mortality rate of our IVIG treated patients was 20%vs. 50%compared to the non-IVIG-group. However, due to the small number of patients and contradictory results in the literature, IVIG cannot be generally recommended for the treatment of TEN, but should be considered in early stages of the disease.Toxic epidermal necrolysis （TEN） is the maximal variant of severe bullous drug reactions with a high mortality rate of 30-40%. Treatment should be interdisciplinary and is best provided in an intensive care setting. Since no specific therapy has been established, supportive intensive care and topical treatment are of crucial importance. Between 1995 and 2005, nine patients with TEN were treated in the anesthesiology intensive care unit in cooperation with dermatology in the University Hospital of Dresden. All patients initially received corticosteroids and five patients were additionally treated with intravenous immunoglobulins （IVIG）. The overall mortality of 33% was underestimated by the SAPS Ⅱ-Score, whereas it was overestimated by the TEN-specific SCORTEN. In more severely affected patients, other scoring systems in addition to SCORTEN should be used for prediction of prognosis and evaluation of therapy. The mortality rate of our IVIG treated patients was 20% vs. 50% compared to the non-IVIG-group. However, due to the small number of patients and contradictory results in the literature, IVIG cannot be generally recommended for the treatment of TEN, but should be considered in early stages of the disease.

关 键 词：中毒性表皮坏死松解症 静脉滴注免疫球蛋白 局部治疗 患者 重症监护病房 德语 皮质激素治疗 评分系统 IVIG 死亡率 

分 类 号：R758.25[医药卫生—皮肤病学与性病学] R745.440.5[医药卫生—临床医学]