儿童葡萄球菌性烫伤样皮肤综合征156例临床分析

Clinical analysis of 156 cases with Staphylococcal scalded skin syndrome in children

目的探讨葡萄球菌性烫伤样皮肤综合征(SSSS)的临床特征、实验室检查及疗效,指导临床诊治,降低误诊率。方法回顾性分析郑州大学第一附属医院156例葡萄球菌性烫伤样皮肤综合征患儿的临床资料,将92例轻症患儿和64例重症患儿随机各分为两组:对照组和治疗组,分别比较两组患儿临床症状改善情况及病程。结果 156例患者发病年龄平均(3.51±0.24)岁,男∶女为1.29∶1,9~11月份发病率明显增高,发病前有明显诱因者40例(25.6%),在当地医院误诊56例(35.9%)。64例重症患儿,治疗组较对照组在临床症状改善方面有明显优势,两组比较差异有统计学意义(P<0.05)。结论葡萄球菌性烫伤样皮肤综合征好发于3~5岁儿童,男多于女,秋季常见;发病前多有明显诱因,基层医院误诊率较高;重症SSSS患者可短期联合应用小量糖皮质激素。

Objective To discuss the clinical manifestation, laboratory examination and clinical effect of the Staphylococcal scalded skin syndrome （SSSS）, so as to guide the clinical diagnosis and treatment, and decrease misdiagnosis rate. Methods The clinical data of 156 children with Staphylococcal scalded skin syndrome were retrospectively analyzed. Then 92 mild cases and 64 severe cases were randomly divided into two groups, i.e. control group and treatment group. The improvement of clinical symptoms and the course of the disease were compared between the two groups respectively. Results The average age of onset was （3.51 ± 0.24） years, male to female ratio was 1.29：1. The incidence increased significantly from September to November. There were 40 patients （25.6%） with obvious causes before onset. And 56 cases （35,9%） were misdiagnosed in the local hospitals. And in the 64 cases of children with severe SSSS, the treatment group had obvious advantage in symptom improvement degree than the control group, the difference between the two groups had statistical significance （P 〈 0.05）. Conclusions Staphylococcus scalded skin syndrome often occurs in 3 to 5 years old children, more in male than in female. It is common in fall. There are many evident causes before onset. The misdiagnosis rate in primary hospitals is high. Patients with severe SSSS can have combined use of small amount of glucocorticoid in the short term.