血液灌流联合连续性肾脏替代疗法治疗重症药疹临床分析

Clinical analysis of severe drug eruption treated with hemoperfusion combined with continuous renal replacement therapy

目的:评价血液灌流(HP)联合连续性肾脏替代疗法(CRRT)治疗重症药疹的疗效。方法:回顾性分析2009年6月—2013年6月该院救治成功的10例重症多形红斑(SJS)及19例中毒性表皮坏死松解症(TEN)患者,根据临床治疗方案分为常规治疗组与HP+CRRT组,比较2组患者治疗前SCORTEN评分,并比较体温控制时间、皮损控制时间及住院天数。结果:2组治疗前SCORTEN评分及总预期病死率的比较差异无统计学意义(P>0.05);2组体温控制时间的比较差异无统计学意义(P>0.05);皮损控制时间的比较差异有统计学意义(P<0.05);HP+CRRT组住院天数短于常规治疗组,差异有统计学意义(P<0.05)。结论:HP联合CRRT是治疗SJS与TEN的有效手段,明显缩短病程。

Objective: To determine the advantages of hemoperfusion(HP) in combination with continuous renal replacement therapy(CRRT) for severe drug eruptions. Method: We retrospectively analyzed 10 cases of Stevens-Johnson syndrome(SJS)and 19 case of toxic epidermal necrolysis(TEN) who were successfully treated in our hospital from June 2009 to June 2013.The SCORTEN scores before treatments, times required to normalize temperature and to stabilize skin lesions, and duration of hospitalization were compared in patients treated with routine versus HP+CRRT treatments. Results: Prior to the treatment, SCORTEN scores and the total expected case fatality rate did not differ between the two groups(P>0.05). The times required to normalize temperature were not significantly different between the two groups(P>0.05). However, the times required to stabilize skin lesions and duration of hospitalization were shorter in HP+CRRT group than in the routine treatment group(P<0.05, for both).Conclusions: HP combined with CRRT is effective for SJS and TEN, and can shorten the duration of diseases.