22例大疱性表皮松解坏死型药疹皮损处理临床回顾  

Retrospective study on the management of skin lesions in 22 patients with toxic epidermal necrolysis

作　　者：张华[1] 郝天智[1] 王方明[2] 高鸿敏[2] 鲁刚[1] 

机构地区：[1]北京军区总医院烧伤整形科,北京100700 [2]北京军区总医院263临床部

出　　处：《实用皮肤病学杂志》2015年第4期274-276,共3页Journal of Practical Dermatology

摘　　要：目的回顾分析全身治疗及综合皮损处理技术救治大疱性表皮松解坏死型药疹的疗效。方法在抗休克、抗感染、抗过敏、治疗原发病灶等系统治疗的基础上,采用脱细胞真皮、纳米银敷料、人工细胞愈合膜、生长因子等新型敷料和药物以及悬浮床、烧伤创面治疗仪、半导体激光等设备治疗皮损。结果 22例患者中19例治愈出院,1例死于肺动脉栓塞,2例死于感染性休克。结论全身治疗可以维持患者内环境的稳定、控制皮损发展、减少感染的发生;悬浮床、气垫床可以避免压迫导致创面加深;纳米银敷料、活性碳敷料可以防治创面感染;脱细胞真皮包扎治疗、烧伤创面治疗仪、半导体激光、生长因子的应用可以加速创面愈合,减轻患者痛苦。Objective To retrospectively analyze the effects of management techniques including systemic and topical therapeutic treatments for patients with toxic epidermal necrolysis（TEN）. Methods The comprehensive therapy based on systemic treatments such as anti-shock, anti-infection, anti-allergic drug and primary disease treatment. Topical treatments for skin lesions included applications of acellular dermal sheet, nano silver dressing, artiifcial cellular healing membrane, growth factor, suspension bed, wound therapeutic apparatus and semi-conductive laser. Results Among these 22 patients, 19 patients were cured and discharged, 1 patient died from pulmonary embolism and 2 patients died from septic shock. Conclusions Systemic measures play key roles in maintaining stability of internal environment, which may control the progression of skin lesions and decrease the incidence of infection. Topical measures also play key roles in TEN treatment, e.g. relieving wound deepening by application of suspension bed, decreasing the incidence of wound infection by nano silver dressing, accelerating wound healing and reducing the pain of patients by application of acellular dermal sheet, artiifcial cellular healing membrane, growth factor and semi-conductive laser, etc.

关 键 词：大疱性表皮松解坏死型药疹 中毒性表皮坏死松解症 纳米银敷料 猪脱细胞真皮敷料 活性炭敷料 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]