儿童葡萄球菌烫伤样皮肤综合征46例临床分析

摘要

目的 回顾性探讨糖皮质激素对葡萄球菌烫伤样皮肤综合征(SSSS)的临床表现、治疗结果的影响.方法 采用随机分组,将46例患儿分为观察组(24例)和对照组(22例),两组均早期足量应用对金黄色葡萄球菌有效的抗生素5~7天.其中观察组在使用足量抗生素的同时合用地塞米松.结果 46例患儿经抗生素或抗生素联合糖皮质激素治疗均痊愈,两组疗效相比无统计学差异(Zc=1.134,P>0.05),病情痊愈时间无统计学差异(t=0.81,P>0.05);而体温恢复时间、红斑颜色变淡时间、触痛消退时间等两组比较,差异均有统计学意义(t值分别为10.17、11.98、7.15,均P<0.01).结论 合用激素并不能缩短病程,但可以有效减轻炎症,促进创面愈合,达到单用抗生素不能取得的良好疗效.因此SSSS患儿联合使用糖皮质激素是安全有效的.%Objective To retrospectively explore the effect of glucocorticoids on clinical manifestations and therapeutic effect on staphylococcal scalded skin syndrome (SSSS).Methods Forty-six cases were randomly divided into observation group (24 cases) and control group (22 cases), and enough-dosage antibiotics effective against Staphylococcus aureus was given to two groups at early stage for 5 to 7 days.The observation group was provided with dexamethasone based on enough antibiotics at the same time.Results All of 46 cases were cured after administration of antibiotics or antibiotics combining glucocorticoid, and the therapeutic effect was not significant different (Zc=1.134, P >0.05).The difference in cure time was not statistically significant (t =0.81, P >0.05).But two groups were significantly different in temperature recovery time, time for fading of erythema and disappearance time of tenderness (t value was 10.17, 11.98 and 7.15, respectively, all P <0.01).Conclusion Combining glucocorticoids administration does not shorten the course of disease, but can effectively reduce inflammation, promote wound healing, and achieve good curative effect that antibiotics alone cannot obtain.So combined use of corticosteroids for children with SSSS is safe and effective.