系统性创面管理在儿童Stevens-Johnson综合征/中毒性表皮坏死松解症治疗中的意义探讨  

Role of systematic wound management in the treatment of Stevens-Johnson syndrome/toxic epidermal necrolysis in children

作　　者：王莹[1] 陈立新[1] 毕田田[1] 李钦峰[1] 廉佳[1] Wang Ying;Chen Lixin;Bi Tiantian;Li Qinfeng;Lian Jia(Department of Dermatology,Tianjin Children′s Hospital,Tianjin 300074,China)

机构地区：[1]天津市儿童医院皮肤科,天津300074

出　　处：《中华皮肤科杂志》2023年第10期940-942,共3页Chinese Journal of Dermatology

基　　金：天津市卫生健康委员会科技项目(RC20125)。

摘　　要：目的探讨系统性创面管理在儿童Stevens-Johnson综合征/中毒性表皮坏死松解症(SJS/TEN)治疗中的意义。方法回顾性分析2019年10月至2021年8月天津市儿童医院皮肤科收治的5例SJS/TEN患儿在药物治疗基础上,加强对皮肤和黏膜损伤系统性创面管理的作用。结果5例2~13岁患儿(1例SJS,1例SJS/TEN重叠征,3例TEN)经甲泼尼龙静脉输注治疗和系统性创面管理后均治愈出院。入院时患儿TEN严重度评分为(18.6±1.9)分,住院第7、10、14天分别为(13.8±1.9)、(4.4±0.5)、(2.0±0.7)分,完成上皮化时间(10±2.1)d,住院时间(14.4±4.16)d;多学科随访4个月,均未见明显瘢痕,眼、口腔、生殖器、肺等黏膜部位未出现并发症。结论系统性创面管理有利于快速控制SJS/TEN病情,缩短创面愈合时间,改善患儿生活质量。Objective To explore the role of systematic wound management in the treatment of Stevens-Johnson syndrome(SJS)/toxic epidermal necrolysis(TEN)in children.Methods Clinical data were collected from 5 children with SJS/TEN,who were admitted to the Department of Dermatology,Tianjin Children′s Hospital from October 2019 to August 2021,and retrospectively analyzed to investigate the role of systematic management of the skin and mucosa wound besides drug therapy in the treatment of SJS/TEN.Results The 5 patients,including 1 case of SJS,1 case of SJS/TEN overlap syndrome,and 3 cases of TEN,were aged 2 to 13 years,and were cured and discharged after the treatment with intravenous methylprednisolone and systematic wound management.Among the 5 children,the severity of TEN scores(STENS)were 18.6±1.9 points at admission,and 13.8±1.9,4.4±0.5,and 2.0±0.7 points on days 7,10,and 14 during hospitalization,respectively;the time to complete re-epithelialization was 10±2.1 days,and the length of hospital stay was 14.4±4.16 days.During 4-month multidisciplinary follow-up,no scars or complications of the eyes,mouth,genitalia,or lungs occurred.Conclusion Systematic wound management is helpful to control the progress of SJS/TEN,accelerate wound healing,and improve patients′quality of life.

关 键 词：儿童 STEVENS-JOHNSON综合征 创面管理 治疗 

分 类 号：R751[医药卫生—皮肤病学与性病学]