中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (1): 49-53.doi: 10.35541/cjd.20210638

• 研究报道 • 上一篇    下一篇

不同浸浴方案对天疱疮患者皮损愈合的影响分析

曹淼1    崇杉2    王明悦1   

  1. 1北京大学第一医院皮肤性病科/护理部  国家皮肤与免疫疾病临床医学研究中心  北京市皮肤病分子诊断重点实验室  国家药品监督管理局化妆品质量控制与评价重点实验室,北京  100034;2北京大学医学部,北京  100191
  • 收稿日期:2021-09-02 修回日期:2022-07-15 发布日期:2023-01-03
  • 通讯作者: 王明悦 E-mail:wangmy@pku.edu.cn
  • 基金资助:
    北京市自然科学基金(7172214)

Effect of different immersion bath methods on the healing of skin lesions in patients with pemphigus

Cao Miao1, Chong Shan2, Wang Mingyue1#br#   

  1. 1Department of Dermatology and Venereology/Nursing Department, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing 100034, China; 2Peking University Health Science Center, Beijing 100191, China
  • Received:2021-09-02 Revised:2022-07-15 Published:2023-01-03
  • Contact: Wang Mingyue E-mail:wangmy@pku.edu.cn
  • Supported by:
    Beijing Municipal Natural Science Foundation(7172214)

摘要: 【摘要】 目的 分析臭氧、1∶8 000高锰酸钾和1∶5 000高锰酸钾浸浴方案对天疱疮患者皮损恢复的影响。方法 回顾2016年1月至2021年6月北京大学第一医院皮肤科住院治疗期间接受浸浴护理的天疱疮患者,比较采用臭氧、1∶8 000高锰酸钾和1∶5 000高锰酸钾浸浴方案的疗效和安全性。分类变量的比较采用卡方检验或Fisher精确检验法,采用单因素及多因素logistic回归分析候选变量与患者出院恢复情况是否良好的关系。结果 纳入74例天疱疮患者,年龄52(41,60)岁[M(Q1,Q3)],男45例(60.81%)、女29例(39.19%),原发皮疹面积占体表面积百分比中位数为40%。接受臭氧浸浴32例、1∶8 000高锰酸钾浸浴25例和1∶5 000高锰酸钾浸浴17例,3组的平均住院时长、平均病程(发病至入院时间)、性别、皮疹面积等差异均无统计学意义(P > 0.05)。患者接受的治疗包括使用糖皮质激素、丙种球蛋白、输注血浆、利妥昔单抗、免疫抑制剂、外用抗生素等,3组间使用以上治疗的患者比例差异均无统计学意义(P > 0.05),但臭氧组系统使用抗生素比例低于两高锰酸钾组(均P < 0.01)。出院时,臭氧浸浴组1例好转,21例基本痊愈,10例痊愈;1∶8 000高锰酸钾浸浴组4例好转,13例基本痊愈,8例痊愈;1∶5 000高锰酸钾浸浴组5例好转,8例基本痊愈,4例痊愈。臭氧浸浴组恢复良好患者比例(31/32例)高于高锰酸钾浸浴组(33/42例),差异有统计学意义(P = 0.036)。单因素及多因素分析显示,臭氧浸浴对患者出院时“恢复良好”的影响有统计学意义(P < 0.05),是患者出院“恢复良好”的独立预测因素(HR = 8.455,95% CI:1.011 ~ 70.672,P = 0.049)。结论 臭氧浸浴对天疱疮患者的皮疹恢复有益。

关键词: 天疱疮, 护理, 浸浴护理, 臭氧, 高锰酸钾, 疗效

Abstract: 【Abstract】 Objective To analyze effects of ozone bath, 1∶8 000 potassium permanganate bath and 1∶5 000 potassium permanganate bath on the recovery of skin lesions in patients with pemphigus. Methods Patients with pemphigus, who received immersion bath treatment during their hospitalization, were retrospectively collected from Department of Dermatology, Peking University First Hospital from January 2016 to June 2021. The efficacy and safety of different immersion bath methods including ozone bath, 1∶8 000 potassium permanganate bath and 1∶5 000 potassium permanganate bath were compared. Categorical variables were compared using chi-square test or Fisher′s exact test, and univariate and multivariate logistic regression models were used to analyze relationships between candidate variables and patients′ condition at discharge. Results A total of 74 patients with pemphigus were included, including 45 (60.81%) males and 29 (39.19%) females, their age (M[Q1, Q3]) was 52 (41, 60) years, and the median percentage of primary skin lesion area in body surface area was 40%. There were no significant differences in hospital stays, disease duration (time from onset to admission), gender ratio or skin lesion areas among patients receiving ozone bath (32 cases), patients receiving 1∶8000 potassium permanganate bath (25 cases) and those receiving 1∶5000 potassium permanganate bath (17 cases, all P > 0.05). These patients still received other treatments, including glucocorticoids, gamma globulin, plasma transfusion, rituximab, immunosuppressants, topical antibiotics, etc., and there was no significant difference in the proportions of patients using the above therapies among the three groups (all P > 0.05), while the ozone bath group showed lower proportions of patients using systemic antibiotics compared with the two potassium permanganate bath groups (both P < 0.01). At discharge, in the ozone bath group, 1 case was improved, 21 were nearly cured, and 10 were cured; in the 1∶8 000 potassium permanganate bath group, 4 cases were improved, 13 were nearly cured, and 8 were cured; in the 1∶5 000 potassium permanganate bath group, 5 were improved, 8 were nearly cured, and 4 were cured. The proportion of well-recovered patients was significantly higher in the ozone bath group (31/32 cases) than in the potassium permanganate bath group (33/42 cases, P = 0.036). Univariate and multivariate analyses showed that ozone bath significantly affected the patients′ condition at discharge (P < 0.05), and was an independent predictor of "good recovery" at discharge (HR = 8.455, 95% CI: 1.011 - 70.672, P = 0.049). Conclusion Ozone bath therapy can facilitate recovery of skin lesions in patients with pemphigus.

Key words: Pemphigus, Nursing care, Bath care, Ozone, Potassium permanganate, Efficacy