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題名 | A Clinical Analysis of the Stevens-Johnson Syndrome=史蒂文﹣強森症候群之臨床分析 |
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作者 | 周貝倫; 周昌德; 李錦發; | 書刊名 | 醫學研究 |
卷期 | 9:2 1988.09[民77.09] |
頁次 | 頁131-138 |
分類號 | 415.96 |
關鍵詞 | 史蒂文強森症候群; Stevens-Johnson Syndrome; |
語文 | 英文(English) |
中文摘要 | 三軍總醫院自民國70年1月至76年12月間,經臨床診斷為史蒂文-強森症候群病患共患共有35例。發生率為0.006%。在35例病患中,男性25位,女性10位,男女比例為2.5:1。年齡從20歲至82歲,平均為44.4±16.6;其中20~30歲為發病尖峯年齡。平均入院前驅症狀有3.8天。在相關致病因的研究中,藥物因素佔首位(80%),其次為感染(54%)臨床表徵方面,所有病患皆出現皮膚病灶及口腔潰瘍。其他症狀包括:發燒(73%),結膜炎(83%),及生殖器潰瘍(40%)等。實驗室的檢查結果,不具診斷特異性。病患平均住院天數為16.6日。治療方面,有24例(69%)接受prednisolone (40~80 mg/qd)治療。其中9例(27.5%)出現合併症,包括食道念珠菌感染3例,肺炎2例,胃潰瘍出血1例,急性腎衰竭1例,指甲脫落1例,及部份眼臉黏合1例。其中1例轉入燒傷中心接受隔離治療。共有3例死亡,死亡率為8.5%;僅2例有復發現象,佔5.7%,敗血症為主要死因。 |
英文摘要 | From January 1981 to December 1987, 35 patients with Stevens-Johnson syndrome were studied at Tri-Service general Hospital, which included 25 males and 10 females. The male to female ratio was 2.5:1. The age tanged from 20 to 82 years with Mean + SD = 44.4 + 16.6 years and with a peak in the second decade. Nineteen patients (54%) had preceding symptoms of fever and sore throat with mean duration of 3.8 days before the onset of skin lesions. The most common etiologic association factor in our series was with drugs (80%), followed by infections (54%). The frequency of clinical manifestations were skin rash (100%), stomatitis (100%), conjunctivitis (83%), fever (73%) and genital ulcer (40%) etc. The abnormal laboratory findings were entirely nonspecific. Gast roscopic examination was performed on five patients and three of them disclosed esophageal candididasis. One patient was treated in the burn center. Average hospitalization was 16.6 days. Twenty-four patients (69%) were treated with prednisolone (40-80mg/qd), while eleven patients (31%) received none. Nine patients (27.5%) had obvious complications and three patients (8.5%) died. Only two patients (5.7%) had recurrences. Sepsis was the leading cause of death. |
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