青光眼手术前后口服醋甲唑胺致Stevens—Johnson综合征

Methazolamide-induced Stevens-Johnson syndrome before and after glaucoma surgery

目的分析青光眼手术前后口服醋甲唑胺引起Stevens—Johnson综合征的临床特点。方法回顾性分析2例因口服醋甲唑胺致药源性Stevens-Johnson综合征的发病过程、皮疹特点、治疗经过及结果。结果醋甲唑胺可能引起药源性Stevens-Johnson综合征，用药后lO余天出现口腔、眼及生殖器等黏膜受损、糜烂，伴全身皮疹，继而出现水疱、大疱、表皮松解剥脱。治疗停用可疑致敏药物，给予全身皮质类固醇、人免疫球蛋白，全身支持治疗及黏膜护理等综合治疗。结论醋甲唑胺降眼压效果良好，但要警惕其可能引起的严重皮肤黏膜变态反应，可能危及生命，需严格掌握用药禁忌证，做好用药前沟通和用药后监护，早期发现皮肤黏膜损害，及时全身综合治疔和护理，尽可能降低危害。

Objective To analyse the clinical characteristics of Stevens-Johnson syndrome induced hy using methazolamide before and after glaucoma surgery. Methods The course of disease,rash characteristics, treatment and therapeutic outcome of two patients of methazolamide-induced Stevens-Johnson syndrome were retrospectively analysed. Results Methazolamide may cause drug-induced Stevens-Johnson syndrome. After 10 days of using it, oral, eye and genital mucosa damaged and got erosion with whole body skin rash. Then a blister, bullosa occurred and epidermolysis stripped. Suspicious allergenic drugs were discontinued. Systemic corticosteroids, immune globulin, the whole body support treatment, mucous membrane care and other comprehensive treatment were given. Conclusion Methazolamide is effective on introcular pressure reduction, but may cause severe skin and mucosa allergy which is life-threatening. So the medical contraindications should be controlled strictly and good communication with patients is also important before treatment. The early detection of skin mucous membrane damage and timely systemic comprehensive treatment is very important.