1例丙戊酸钠致Stevens-Johnson综合征/中毒性表皮坏死松解症案例分析  

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Induced by Sodium Valproate:A Case Report

作　　者：邓静 张培明 李耀伟 DENG Jing;ZHANG Peiming;LI Yaowei(The People's Hospital of Guang'an,Guang'an,Sichuan,China 638099)

机构地区：[1]四川省广安市人民医院,四川广安638099

出　　处：《中国药业》2024年第8期120-124,共5页China Pharmaceuticals

基　　金：四川省广安市人民医院推动高质量发展基金[21FZ005]。

摘　　要：目的为临床诊治丙戊酸钠所致重症药疹提供参考。方法回顾性分析1例脑出血术后患者使用丙戊酸钠引起Stevens-John-son综合征/中毒性表皮坏死松解症(SJS/TEN)的治疗过程,并采用诺氏评估量表进行关联性评价。结果丙戊酸钠与SJS/TEN的关联性为“很可能”(诺氏评估量表评分为6分)。经停药、补液、血浆置换、糖皮质激素冲击和序贯治疗及抗感染等治疗后,患者全身皮疹好转。结论临床使用丙戊酸钠时应警惕重症药疹的发生。使用前应仔细询问患者的病史及过敏史,一旦怀疑为药疹,应立即停用可疑药物,并根据药疹的严重程度制订治疗方案。Objective ide a reference for the clinical diagnosis and treatment of se cal diagnosis and treatment of severe drug eruption induced valproate.Methods The treatment process of Stevens-Johnson syndrome/toxic epidermal necrolysis(SJS/TEN)induced by the use of sodium valproate in a postoperative patient with cerebral hemorrhage was retrospectively analyzed,and the association of the adverse drug reaction(ADR)with the drug was evaluated by the Naranjo′s ADR evaluation scale.Results Sodium valproate was probably associated with SJS/TEN(the Naranjo′s ADR evaluation scale was six points).After drug withdraw,fluid replacement,plasma exchange,glucocorticoid implosive and sequential therapy and anti-infection treatment,the patient′s overall rash improved.Conclusion We should be alert to the occurrence of severe drug eruption when using sodium valproate in clinical practice,and carefully inquire about the patients′medical and allergy history before use.Once drug eruption is suspected,we should immediately stop using the suspicious drug and formulate a treatment regimen based on the severity of the ADR.

关 键 词：丙戊酸钠 脑出血 重症药疹 STEVENS-JOHNSON综合征 中毒性表皮坏死松解症 药品不良反应 

分 类 号：R969.3[医药卫生—药理学]