重症多形红斑与中毒性表皮坏死松解症患者的感染分析  

Clinical characteristics of severe erythema multiforme and toxic epidermal necrolysis patients complicated with infections

作　　者：楼小航[1] 刘继峰[1] 吴纪龙[1] 邢臣径[1] 陈娜[2] 

机构地区：[1]杭州市第三人民医院皮肤科,浙江杭州310009 [2]杭州市第三人民医院康复科,浙江杭州310009

出　　处：《中华医院感染学杂志》2016年第10期2281-2283,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2013KYB2690);杭州市科学技术局基金资助项目(20110833B12)

摘　　要：目的探讨重症多形红斑与中毒性表皮坏死松解症患者合并感染的临床特征及治疗方法,为临床治疗提供有效手段。方法对2007年6月-2014年7月收治的104例重症多形红斑及中毒性表皮坏死松解症患者临床资料进行回顾性分析,患者入院后立刻停用致敏药物,给予以保护性隔离,根据激素是否联合使用人免疫球蛋白将患者分为A、B两组,在此基础上给予相关治疗,对比评价两组患者的临床疗效及感染情况。结果经治疗后,A组患者痊愈37例、痊愈率达68.52%,好转16例、好转率29.63%,死亡1例、病死率1.85%;B组患者痊愈30例、痊愈率达60.00%,好转14例、好转率28.00%,死亡6例、病死率12.00%,B组痊愈率、好转率均低于A组,差异有统计学意义;病死率显著高于A组,差异有统计学意义(P<0.05);两组患者合并感染情况差异无统计学意义;A组患者退热时间、住院时间、皮损愈合时间均少于B组,差异有统计学意义(P<0.05);在不良反应方面,B组血糖升高、股骨头坏死的发生率均高于A组,差异无统计学意义。结论重症多形红斑及中毒性表皮坏死松解症患者感染率很高,要注重皮肤护理,预防感染,同时使用人免疫球蛋白及激素联合治疗可有效提高临床疗效。OBJECTIVE To explore the clinical characteristics of severe erythema multiforme and toxic epidermal necrolysis patients complicated with infections and put forward the treatment measures so as to provide guidance for clinical treatment.METHODS The clinical data of 104 severe erythema multiforme and toxic epidermal necrolysis patients complicated with infections who were treated in the hospital from Jun 2007 to Jul 2014 were retrospectively analyzed,the allergenic drugs were immediately withdrawn after the patients were enrolled in the hospital,and the protective isolation was conducted.The patients were divided into the group A and the group B on the basis of the use of hormones in combination with human immunoglobulin,the additional relevant therapies were carried out,and the clinical effects and incidence of infections were observed and compared between the two groups of patients.RESULTS After the treatment,the cure rate of the group A was 68.52%（37cases）,higher than 60.00%（30cases）of the group B;the improvement rate of the group A was 29.63%（16cases）,higher than 28.00%（14cases）of the group B;the mortality rate of the group A was 3.84%（2cases）,significantly lower than 12.00%（6cases）of the group B（P〈0.05）.The cure rate and improvement rate were lower in the group B than in the group A,with statistical significance（P〈0.05）.There was no significant difference in the incidence of complicated infections between the two groups of patients.The fever clearance time,length of hospital stay,and healing time of skin lesions were significantly shorter in the group A than in the group B（P〈0.05）.With the respect to adverse reactions,the incidence rates of elevated blood glucose and femoral head necrosis were higher in the group B than in the group A,and there was no significant difference.CONCLUSION The infection rate is so high in the patients with severe erythema multiforme and toxic epidermal necrolysis that it is necessary to pay attention to the skin care and prevention of infec

关 键 词：中毒性表皮坏死松解症 重症多形红斑 感染 临床疗效 

分 类 号：R593.2[医药卫生—内科学]