Jones W G, Halebian P, Madden M, Finkelstein J, Goodwin C W
Burn Center, Department of Surgery, New York Hospital-Cornell University Medical Center, New York City 10021.
J Pediatr Surg. 1989 Feb;24(2):167-70. doi: 10.1016/s0022-3468(89)80240-4.
Nine pediatric patients with drug-induced toxic epidermal necrolysis were treated with a regimen of basic burn care and without the use of steroids or topical or systemic antimicrobial agents. Although septic complications continue to occur frequently, infections are better tolerated when potential iatrogenic sources of decreased host resistance, such as steroids, are eliminated. Neutropenia, gram-negative sepsis, and mortality were all greatly reduced with this regimen, while healing was neither impaired nor prolonged. Thus, steroids and sulfa-containing topical agents should be avoided in the treatment of this disorder.
9名药物性中毒性表皮坏死松解症患儿接受了基本烧伤护理方案的治疗,未使用类固醇、局部或全身抗菌药物。尽管脓毒症并发症仍频繁发生,但当消除潜在的医源性宿主抵抗力降低因素(如类固醇)时,感染更易耐受。采用该方案后,中性粒细胞减少、革兰氏阴性菌败血症和死亡率均大幅降低,同时愈合未受损害也未延长。因此,在治疗这种疾病时应避免使用类固醇和含磺胺的局部用药。