中华皮肤科杂志 ›› 2018, Vol. 51 ›› Issue (12): 896-898.doi: 10.3760/cma.j.issn.0412-4030.2018.12.010

• 研究报道 • 上一篇    下一篇

单纯单次血浆置换疗法治疗17例中毒性表皮坏死松解症临床观察

韩锋    张静静    侯彦丽    王晓鹏    安金刚    王小闯    李满祥    王岗   

  1. 710004 西安交通大学第二附属医院重症医学科（韩锋、侯彦丽、王小闯），急诊科（张静静、王岗），皮肤科（王晓鹏、安金刚）；西安交通大学第一附属医院呼吸与危重症医学科（李满祥）

  • 收稿日期:2018-01-22 修回日期:2018-09-21 出版日期:2018-12-15 发布日期:2018-11-30
  • 通讯作者: 韩锋 E-mail:mailhan@126.com

Efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis in 17 cases: a clinical observation

Han Feng, Zhang Jingjing, Hou Yanli, Wang Xiaopeng, An Jingang, Wang Xiaochuang, Li Manxiang, Wang Gang   

  1. Department of Critical Care Medicine, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China （Han F, Hou YL, Wang XC）; Department of Emergency Medicine, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China （Zhang JJ, Wang G）; Department of Dermatology, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China （Wang XP, An JG）; Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710061, China （Li MX）
  • Received:2018-01-22 Revised:2018-09-21 Online:2018-12-15 Published:2018-11-30
  • Contact: Han Feng E-mail:mailhan@126.com

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摘要： 目的 探讨单纯单次血浆置换（POPE）治疗中毒性表皮坏死松解症（TEN）患者的疗效及不良反应。方法 收集2010年9月至2017年12月在西安交通大学第二附属医院接受单纯单次血浆置换治疗的TEN患者，回顾性分析患者的疾病严重程度、临床疗效、住院时间和不良反应等。结果 共纳入17例患者，年龄（36.1 ± 25.4）岁，男9例，女8例，SCORTEN评分（2.1 ± 1.24）分，STENS评分治疗前为（29.9 ± 6.6）分，治疗后为（3.5 ± 1.8）分。17例患者中，单纯单次血浆置换后15例临床治愈，1例有效，1例死亡。ICU治疗时间（6.4 ± 1.8） d，总住院时间（12.1 ± 5.7） d。住院第1、4、7、10、20天时STENS评分之间差异有统计学意义（F = 18.569，P < 0.05）。除2例患者发生血浆过敏外，无其他相关显著不良反应发生。结论 单纯单次血浆置换疗法治疗TEN疗效显著，无明显不良反应。

关键词: 表皮坏死松解症, 中毒性； 血浆置换； 治疗结果

Abstract: Han Feng, Zhang Jingjing, Hou Yanli, Wang Xiaopeng, An Jingang, Wang Xiaochuang, Li Manxiang, Wang Gang Department of Critical Care Medicine, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China （Han F, Hou YL, Wang XC）; Department of Emergency Medicine, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China （Zhang JJ, Wang G）; Department of Dermatology, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China （Wang XP, An JG）; Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710061, China （Li MX） Corresponding author: Han Feng, Email: mailhan@126.com 【Abstract】 Objective To evaluate the clinical efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis（TEN）, and to investigate its adverse reactions. Methods Patients with TEN receiving single-session plasmapheresis therapy alone were collected from the Second Affiliated Hospital of Xi′an Jiaotong University between September 2010 and December 2017. Clinical data on the disease severity, clinical efficacy, hospitalization duration and adverse reactions were analyzed. Results A total of 17 patients with TEN were enrolled into this study, including 9 males and 8 female, with an average age of 36.1 ± 25.4 years. Their initial SCORTEN and STENS scores were 2.1 ± 1.24 and 29.9 ± 6.6 respectively. After treatment, the STENS score decreased to 3.5 ± 1.8. Of the 17 patients, 15 were cured after single-session plasmapheresis therapy, 1 showed response to the treatment, and 1 died. The duration of intensive care unit stay was 6.4 ± 1.8 days, and the total hospitalization duration was 12.1 ± 5.7 days. There was no significant difference in the STENS score among the day 1, 4, 7, 10 and 20 after hospital admission （F = 18.569, P < 0.05）. No severe adverse reactions were observed, except 2 cases of plasma allergy. Conclusion Single-session plasmapheresis therapy alone is effective for the treatment of TEN without obvious adverse reactions.

Key words: Epidermal necrosis, toxic, Plasma exchange, Treatment outcome