职业性三氯乙烯药疹样皮炎52例临床分析

Clinical Analysis on 52 Cases of Occupational Medicamentosa-like Dermatitis Induced by Trichloroethylene

目的探讨职业性三氯乙烯(TCE)药疹样皮炎的早期诊断和治疗经验。方法对52TCE药疹样皮炎患者的临床资料进行回顾性分析。结果发病潜伏期为5～122d,平均36.8d。住院前非正规治疗时间为3～20d,平均10.7d。总发热47例(90.4%),皮疹52例(100.0%),ALT或AST活力增高52例(100.0%),剥脱型皮炎37例(71.2%),多型红斑11例(21.2%),重型多形红斑3例(5.8%),大疱表皮松懈坏死症1例(1.9%)。痊愈49例,好转自动出院3例,治愈好转率100.0%。平均住院病程73.5d,使用糖皮质激素平均时间68.9d。结论对接触TCE者,一旦出现发热、皮疹或感冒等症状,应首先考虑到TCE药疹样皮炎的可能性。TCE药疹样皮炎除发热、皮疹外,多伴肝功能异常。早期、足量使用糖皮质激素可有效控制病情。

[Objective]To study the early diagnosis and treatment experience of occupational medicamentosa-like dermatitis caused by trichloroethylene （TCE）.[Methods]The clinical data of 52 patients with TCE-induced medicamentosa-like dermatitis were analyzed retrospectively.[Results]The latent period varied from 5 to122 days,and average was 36.8 days. The time of non-regular treatment before hospitalization ranged from 3 to 12 days,and average was 10.7 days. There were 47 cases with fever （90.3%）,52 cases with dermatitis （100.0%）,52 cases with activity increasing of ALT or AST （100.0%）,37 cases with exfoliative dermatitis （71.2%）,11 cases with polymorphous erythema （21.2%）,3 cases with serious polymorphous erythema （5.8%） and 1 case with bullous epidermal necrosis （1.9%）.The cure rate was 100.0%,and 3 cases was automatic discharge. The average hospitalization time was 73.5 d,and the average time of glucocorticoid therapy was 68.9 days.[Conclusion]If fever,dermatitis and common cold occurred in the patient exposed to TCE,it was considered as TCE-induced medicamentosa-like dermatitis at first. Besides fever and dermatitis,TCE-induced medicamentosa-like dermatitis is often accompanied by hepatic dysfunction. The glucocorticoid therapy with full quality in time is effective.