葡萄球菌性烫伤样皮肤综合征35例临床分析

Clinical Analysis of 35 Cases of Staphylococcal Scalded Skin Syndrome

目的探讨葡萄球菌性烫伤样皮肤综合征(SSSS)的发病诱因、皮损特点及治疗。方法收集35例SSSS患儿的临床资料,从诱发因素、皮疹特点、实验室检查及治疗效果等方面进行分析。结果患儿多有弥漫性潮红斑、松弛性大疱或大片表皮剥脱,口周有特殊性放射状皲裂,触痛明显,患儿拒抱;27例分泌物培养有金黄色葡萄球菌生长;20例组织病理示表皮颗粒层有裂隙;首选抗生素(头孢曲松钠、苯唑西林钠0.05～0.1g/kg.d)治疗,9例严重者加用糖皮质激素(地塞米松2～5mg/d),另8例联合丙种球蛋白治疗(0.4g/kg.d,共3天);皮损局部对症处理,多在11天内痊愈。结论SSSS是一种重症感染性疾病,在正确选用抗生素的基础上,应用激素及丙种球蛋白,加强护理,可获得满意疗效。

Objective To investigate the pathogen, skin lesions and treatment of staphylococcal scalded skin syndrome （SSSS）. Method 35 patients were entrolled to analyze their induced factors, rash features, laboratory tests and effects of treatment. Results All of the patients presented with diffused flushing erythema, lusitropic bulla or a sheet of superficial exfoliation and specific radiated rhagas around oral, which made the infants painful and unlike to be embraced. Bacterial cultures showed staphylococcus aureus in 27 cases, while histological examination in 20 cases revealed crevice on the granular layers of epidermis. All the cases was given antibiotics at first, 9 of which were also treated with corticosteroids （DX 2 -5 mg/d） and 8 with IVIG （r-Globulin 0.4g/kg. d × 3d）. After taking primary care of lesions, most of the patients recovered during 11 days. Conclusion SSSS is a severe inflammatory disease which could be well treated with antibiotics, corticosteroid, IVIG as well as intensive care together with appropriate antibiotics.