儿童抗癫痫药物超敏综合征临床特征及其护理干预策略分析

Clinical Features and Nursing Intervention Strategy of Anticonvulsant Hypersensitivity Syndrome in Children

目的分析儿童抗癫痫药物超敏综合征(AHS)的临床特征及其护理干预策略。方法选取电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院儿童神经科2007年10月-2017年9月收治的AHS患儿32例,回顾性分析其临床表现、并发症发生情况及临床转归,并总结其护理干预策略。结果32例AHS患儿中出现发热24例,粟粒样皮疹15例,Stevens-Johson综合征(SJS)8例,中毒性表皮松解症(TEN)5例,伴口腔黏膜溃疡8例,唇及眼周红肿糜烂6例,会阴糜烂2例;出现单核细胞及嗜酸粒细胞计数升高21例,肝功能损伤13例,心肌损伤7例,肾功能损伤2例。32例AHS患儿经1~4周治疗及护理后均痊愈出院。结论儿童AHS主要临床表现为发热、皮疹和脏器损伤,对护理人员要求较高,因此应熟练掌握其临床特征以提高护理预见性,改善患儿预后。

Objective To analyze the clinical features and nursing intervention strategy of anticonvulsant hypersensitivity syndrome(AHS)in children.Methods From October 2007 to September 2017,a total of 32 children with AHS were selected in the Department of Child Neurology,Chengdu Women’s and Children’s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,after that the clinical manifestations,incidence of complications and clinical outcome were retrospectively analyzed,and the nursing intervention strategy was summarized.Results Of the 32 children with AHS,24 cases occurred fever,15 cases occurred miliary rashes,8 cases occurred StevensJohson syndrome,5 cases occurred toxic epidermal necrolysis(TEN),8 cases accompanied with oral mucosal ulcer,6 cases accompanied with red and swollen/erosion around lips and eyes,2 cases accompanied with perineum erosion;21 cases complicated with increase of monocytes and eosinophils,13 cases complicated with hepatic injury,7 cases complicated with myocardial damage,2 cases complicated with renal injury.All of the 32 children with AHS were cured and discharged after 1 to 4 weeks of treatment and nursing intervention.Conclusion AHS mainly performs as fever,rash and organ injury in children,which requires relatively high quality of nursing staff,thus skillfully mastering the clinical features is helpful to improve the nursing foresight and the prognosis of children.