18例儿童重症多形性红斑型药疹的护理实践与效果观察  

Clinical nursing practice and effect observation of 18 cases of children with Stevens-Johnson syndrome

作　　者：胡丹[1] 袁昌蓉[1] 尹兴娅[1] 蓝娅[1] 秦琴 冯娇 Hu Dan;Yuan Changrong;Yin Xingya;et al(Children＇s Hospital of Chongqing Medical University, Chongqing, 40000)

机构地区：[1]重庆医科大学附属儿童医院口腔眼科皮肤病房儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室,重庆400000

出　　处：《当代护士（下旬刊）》2018年第1期99-101,共3页Modern Nurse

基　　金：2013-2014年度国家临床重点专科建设项目(临床护理)(国卫办医涵[2013]544号)

摘　　要：目的探讨运用科学有效的护理方法减轻患儿痛苦,减少并发症,提高治愈率。方法选择我院皮肤科病房2013年11月-2016年3月收治的18例重症多形性红斑型药疹患儿,从影响疾病的相关因素、治疗方法、护理要点及效果观察,首次应用人工皮对本病进行辅助治疗等方面进行分析总结。结果 18例患儿通过6-28 d(平均17 d)的系统治疗和精心护理,17例痊愈出院(94.4%),1例合并重症感染病情危重转入PICU后治疗无效死亡(5.6%)。人工皮辅助治疗1例,皮肤转归情况良好。结论去除病因,合理选择抗生素,早期使用皮质类固醇激素联合丙种球蛋白,可缩短病程,加速皮疹消退;严密观察病情,专业的皮肤黏膜护理,防止水电解质紊乱,做好营养支持,加强预防和控制感染是度过危险期和走向康复的关键。做好患儿及家属的心理疏导工作,获得其认同及信任,帮助其树立信心,亦对疾病康复起积极作用。Objective To explore the scientific and effective nursing methods to reduce the pains of the children with Steven-Johnson, reduce complications and improve the cure rate.Methods From November 2013 to March 2016 altogether 18 children with Stevens-Johnson from our dermatology wards were chose to analysis and summary their relevant factors, therapeutic methods, nursing essentials, clinical effects and first adjuvant therapy of artificial skin.Results 18 children with 6-28 d （ average 17 d） of systematic treatment and careful nursing, 17 cases recovered and discharged （94.4%） , 1 cases with severe infection were critically ill and transferred to PICu after treatment invalid death （5. 6% ）. 1 cases were treated with artificial skin, and the skin turnover was good. Conclusion Removing causes, applying antibiotics reasonably and combined utilization of corticosteroid and gamma globulin earlier can cut down the course of the disease and accelerate degrading of rash. The key points of passing crisis and going toward healing are close observation, professional nursing of skin and mucous membrane, preventing electrolyte disturbances, good nutritional support, prevention and control of infection. Providing better psychological guidance of children and parents, gaining their acceptance and trust, helping their confidence building are also have positive effects on recovery.

关 键 词：儿童 药疹 皮且走/黏膜护理 人工皮 

分 类 号：R473.72[医药卫生—护理学]