血液净化与常规方法治疗儿童重型渗出性多形性红斑的疗效比较
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- 英文论文题名：A comparative study on children with erythema multiforme majus syndrome
- 论文作者：刘士珍 ; 赵春 ; 刘海燕 ; 王玉娟 ; 王伟 ; 刘金龙 ; 靳有鹏
- 英文论文作者：Liu Shizhen ; Zhao Chun ; Liu Haiyan ; Zoucheng People's Hospital ; Shandong Provincial Hospital affiliated to Shandong University
- 年：2017
- 作者机构：邹城市人民医院儿科;山东大学附属省立医院小儿重症医学科;
- 论文关键词：重型渗出性多形性红斑 ; 儿童 ; 血液净化
- 英文论文关键词：Severe erythema multiforme majus ; Children ; Blood purification
- 会议召开时间：2017-05-26
- 会议录名称：2017年《中国组织化学与细胞化学杂志》临床研讨会论文集
- 语种：中文
- 分类号：R725.9
- 学会代码：ZHXB
- 会议名称：2017年《中国组织化学与细胞化学杂志》临床研讨会
- 会议地点：中国湖北武汉
- 主办单位：《中国组织化学与细胞化学杂志》社有限公司
- 学会名称：《中国组织化学与细胞化学杂志》社有限公司
- 页数：2
- 文件大小：265k
- 原文格式：O
- 会议级别：全国
摘要
目的:比较血液净化治疗与单纯激素加丙球治疗儿童重型渗出性多形性红斑的疗效和并发症。方法:回顾性收集2010年8月-2016年3月我院PICU收治的重型渗出性多形性红斑住院患儿30例,按照其治疗方法分成血液净化治疗组和激素丙球治疗组,比较两组患儿的疗效和并发症。结果:30例患儿中,男18例,女12例,年龄最大13岁,最小2月,平均(3.6±2.9)岁。其中血液净化治疗组10例,单纯激素加丙球治疗组20例,血液净化组(10例)是在应用大剂量静脉注射丙种球蛋白加糖皮质激素的同时,加用血浆置换、血液滤过等血液净化的方法;激素丙球组(20例)是仅应用大剂量静脉注射丙种球蛋白加糖皮质激素治疗,两组患儿均采用同样方式加强对皮肤、粘膜及眼部护理并停用可能的过敏药物。30例患儿无1例死亡,均痊愈或好转转科。比较两组患儿的危重病例评分、治疗后发热持续时间、皮损消失时间及粘膜损伤消失时间,血液净化治疗组患儿的危重程度更高,而发热持续时间、皮损消失时间及粘膜损伤消失时间均短于激素丙球治疗组,两组间比较均有显著意义。结论:血液净化治疗用于重型渗出性多形性红斑能取得更好的疗效,尤其对于病情危重患儿,应及时应用,可挽救更多患儿的生命。
Objective:To compare the effect of blood purification therapy with steroid-immunoglobulin therapy in children with severe erythema multiforme majus.Method:The clinical data of 30 children admitted between 2010 and 2016 were retrospectively reviewed.These children were separated into two groups according to the therapeutic method.Results:No death occurred in two groups.The result showed that the duration of fever and majus was shorter in blood-purification group comparing with steroid-immunoglobulin group,as well as the duration of mucosal lesions.Conclusion:The blood purification therapy is more effective for children with severe erythema multiforme majus.It can decline the mortality.
Objective:To compare the effect of blood purification therapy with steroid-immunoglobulin therapy in children with severe erythema multiforme majus.Method:The clinical data of 30 children admitted between 2010 and 2016 were retrospectively reviewed.These children were separated into two groups according to the therapeutic method.Results:No death occurred in two groups.The result showed that the duration of fever and majus was shorter in blood-purification group comparing with steroid-immunoglobulin group,as well as the duration of mucosal lesions.Conclusion:The blood purification therapy is more effective for children with severe erythema multiforme majus.It can decline the mortality.
引文
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[8]陈金波,王宝玺,王宏伟,等.Stevens-Johnson综合征及中毒性表皮坏死松解症61例回顾性分析[J].中华皮肤科杂志,2008,41(8):542.
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[2]吴娟,曾华松.重型渗出性多型红斑合并哮喘持续状态、肺闭锁综合征1例报告[J].中华临床免疫和变态反应杂志,2008,14(304):292-293.
[3]Hunger RE,Hunziker T,Buettiker U,et al.Rapid resolution of toxicepidermal necrolysis with anti-TNF-alpha treatment[J].J Allergy Clin Immunol,2005,1 16(4):923-924
[4]Shay E,Kheirkhah A,Liang L,et al.Amniotic membrane transplantation as a new therapy for the acute ocular manifestations of StevensJohnson syndrome and toxic epidermal necrolysis[J].Surv Ophthalmol,2009,54(6):686-696.
[5]Harr T,French LE.Toxic epidermal necrolysis and Stevens-Johnson syndrome[J].Orphanet J Rare Dis,2010,5(2):39-49.
[6]Mukasa Y,Craven N.Management of toxic epidermal necrolysis and related syndromes[J].Postgrad Med J,2008,84(988):60-65.
[7]杨永生,徐金华,李锋,等.静脉注射丙种球蛋白和糖皮质激素治疗重症大疱性药疹65例[J].中华皮肤科杂志,2009,42(5):330-332.
[8]陈金波,王宝玺,王宏伟,等.Stevens-Johnson综合征及中毒性表皮坏死松解症61例回顾性分析[J].中华皮肤科杂志,2008,41(8):542.
[9]周小勇,孔庆云,周飞红,等.重症多形性红斑/中毒性表皮坏死松解症29例临床分析.临床皮肤科杂志,2010,39(12):758-759.