小儿葡萄球菌烫伤样皮肤综合征18例临床分析

Clinical analysis of 18 cases of staphylococcal scalded skin syndrome in young children

目的 :了解小儿葡萄球菌烫伤样皮肤综合征 (SSSS)的临床特点及治疗措施。方法 :回顾性分析 1994年 10月～ 2 0 0 1年 3月间 18例 9d～ 3岁小儿SSSS的临床表现、治疗措施及其疗效。结果 :全部均有泛发性红斑及皮肤触痛 ;除 3例无表皮剥脱及尼氏征阴性之外 ,余者的剥脱面积为 5 %～ 6 9 5 %(平均 2 6 8%)。 7例作创面分泌物细菌培养 ,仅 1例金黄色葡萄球菌阳性。及时联用新青霉素Ⅱ与头孢菌素、适当的局部处理使裸露创面在 7～ 10d完全愈合 ,全部痊愈出院。结论 :SSSS好发于新生儿及婴幼儿 ,母乳喂养似对发病无保护作用。早期诊断、及时应用耐 β -内酰胺酶抗生素及适当的局部处理是治疗的关键。

Objective:To study clinical characteristics and treatment regimen of staphylococcal scalded skin syndrome(SSSS)in young children.Methods:Eighteen patients with SSSS aged 9 days-3 years were collected from October 1994 to March 2001,and their clinical manifestations,treatment regimen and therapeutic efficacy were analysed retrospectively.Results:There were generalised erythema and skin tenderness in all cases.All but three had positive Nikolsky's sign and denuded areas ranging from 5% to 69.5%(mean 26.8%).Skin culture was made in 7 cases,and Staphylococcus aureus was isolated from only one.The denuded surface healed in 7-10 days after managed with prompt antibiotics(combined oxacillin with cephalosporin)and appropriate topical treatment,and all patients were quite recovered.Conclusion:SSSS usually occurs in neonates,infants and young children,and breast feeding may not be protective against development of SSSS.Early diagnosis,timely therapy with β-lactamase resistant antibiotics,and suitable topical treatment are the pivotal regimen for this entity.