【摘要】： 背景:藥疹是藥物不良反應(yīng)中的一種類型,也是皮膚科的常見病。近年來,隨著新藥的不斷上市及廣泛應(yīng)用于臨床,藥物的使用頻率及數(shù)量不斷的增加,導(dǎo)致藥疹的發(fā)病率越來越高,特別是重癥藥疹,由于其發(fā)病急、病情重,且易并發(fā)重要臟器損害、威脅患者生命,尤應(yīng)引起臨床醫(yī)師的重視。 目的:探討藥疹發(fā)生的致病因素、臨床特征及防治方法。 方法:對汕頭大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院皮膚性病科2008年12月～2010年2月期間,收治確診的22例藥疹患者的臨床資料,分別從發(fā)病的一般情況(性別、年齡、潛伏期)、致敏藥物、臨床表現(xiàn)、治療方法及轉(zhuǎn)歸等方面進行分析。 結(jié)果:(1)一般情況:總共22例藥疹患者,其中男7例,女15例,男女比例1:2.1,年齡在10歲—60歲之間,平均年齡33歲。潛伏期x從數(shù)小時—20余天不等。(2)致敏藥物:抗生素類9例;抗癲癇藥3例;抗痛風(fēng)藥2例;抗甲狀腺功能亢進藥物1例;同時使用抗生素及解熱鎮(zhèn)痛劑無法確定為何種藥物者2例;使用多種藥物,無法判斷具體致敏藥者2例;有服用中草藥,但具體致敏藥物不詳者3例。(3)臨床類型:大皰性表皮松解壞死型藥疹9例;重癥多形紅斑型藥疹2例;紅皮病型藥疹1例;固定型藥疹1例;麻疹型藥疹4例;急性泛發(fā)性發(fā)疹性膿皰病5例。(4)治療方法:①所有患者均停用所有可疑的致敏藥物。②予以靜脈輸液加速藥物排泄。③予以抗阻胺藥、維生素C、葡萄糖酸鈣等抗過敏治療。④予以糖皮質(zhì)激素治療,劑量相當(dāng)于強的松33mg-150mg/d,部分患者聯(lián)合使用丙種球蛋白治療。⑤予以對癥支持等治療。(5)轉(zhuǎn)歸:全部患者均治愈,治愈率100%。 結(jié)論:(1)藥疹可發(fā)生在任何年齡段,其主要的致病藥物為抗生素類。(2)重癥藥疹發(fā)病急、病情重,需及早作出正確的判斷及給予有效的治療。(3)及早給予足量的糖皮質(zhì)激素仍為治療藥疹、尤其是重癥藥疹的有效措施。(4)糖皮質(zhì)激素聯(lián)合靜脈滴注丙種球蛋白在重癥藥疹治療方面療效滿意。(5)復(fù)方甘草酸苷在藥疹治療中起到積極的作用。
[Abstract]:Background: drug rash is a type of adverse drug reactions and a common disease in dermatology. In recent years, with the continuous marketing of new drugs and their wide application in clinic, the frequency and quantity of drugs are increasing, resulting in a higher and higher incidence of drug rashes, especially severe drug rashes, because of their acute onset and serious illness. And easy to be complicated with important organ damage, threatening the lives of patients, especially should be paid attention to by clinicians. Objective: to investigate the pathogenic factors, clinical features and prevention and treatment of drug eruption. Methods: from December 2008 to February 2010, 22 patients with drug eruption were admitted to the Department of Dermatology, the first affiliated Hospital of Medical College of Shantou University. The clinical data of 22 patients with drug eruption were analyzed from the general condition (sex, age, incubation period). The sensitizing drugs, clinical manifestations, treatment methods and prognosis were analyzed. Results: (1) General situation: there were 22 patients with drug eruption, including 7 males and 15 females, the ratio of male to female was 1 鈮，

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