毒性表皮解复杂的儿童呼吸衰竭:一个病例报告
1Department of Pediatrics, The First People's Hospital of Foshan 528000, Guangdong. China.
Heliyon
|February 21, 2024
概括
早期治疗儿童的斯蒂文斯-约翰逊综合征或有毒表皮解体 (SJS/TEN),后者因呼吸衰竭而复杂,可能无法预防慢性气道损伤. 需要对TNF-α抑制剂等向疗法的进一步研究.
科学领域:
- 儿科肺病学 儿科肺病学
- 皮肤病学 皮肤病学
- 关键护理医学 关键护理医学
背景情况:
- 史蒂文斯-约翰逊综合征或有毒表皮解体 (SJS/TEN) 是一种严重,快速进展的粘膜皮肤反应,死亡率高.
- 呼吸衰竭是严重SJS/TEN的关键并发症,可能导致长期的气道后果.
- 早期SJS/TEN治疗对儿科患者慢性气道损伤的影响尚不完全理解.
研究的目的:
- 研究早期干预对患有SJS/TEN和呼吸衰竭的儿童慢性气道损伤的影响.
- 评估组合疗法的有效性,包括TNF-α抑制剂,用于管理与SJS/TEN相关的呼吸道并发症.
- 突出儿童SJS/TEN幸存者的慢性呼吸道疾病的持续挑战.
主要方法:
- 对三名患有SJS/TEN并发性呼吸衰竭的儿科患者的病例系列分析.
- 干预措施包括高剂量葡萄糖皮质体,马球蛋白脉冲疗法和血交换.
- 评估治疗反应和长期呼吸道结果,包括使用TNF-α抑制剂.
主要成果:
- 一名患者出现了复发性肺部感染和慢性阻塞性肺部疾病,尽管皮肤愈合,但因呼吸衰竭而死亡.
- 两名患者通过包括TNF-α抑制剂在内的组合治疗得到改善,但仍呈现并发性慢性呼吸道疾病.
- 标准的早期治疗不能完全防止该队列的慢性呼吸道后续病变的发展.
结论:
- 患有呼吸衰竭并发症的SJS/TEN的儿科患者有持续的慢性气道损伤的风险,尽管早期和积极的治疗.
- 瘤亡因子-α (TNF-α) 抑制剂可能提供一些益处,但不能消除慢性呼吸道疾病的风险.
- 多中心研究对于探索向治疗的有效性和安全性至关重要,例如TNF-α抑制剂,以改善儿科SJS/TEN的长期呼吸结果.
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