| 皮肤科病房危重症1 057例临床分析 |
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| 引用本文： | 龙海 蒋丽 邱月棨 姚南 刘力聪 谢昱明 熊峰 谭思齐 匡琪琪 尤睿璇 柴可 罗鑫 龙浩君 忻悦 郭子瑜 王佳琪 谭怡忻 张庆 张桂英 李亚萍 苏玉文 肖嵘 陆前进. 皮肤科病房危重症1 057例临床分析[J]. 中华皮肤科杂志, 2021, 54(9): 790-797. DOI: 10.35541/cjd.20210549 |
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| 作者姓名： | 龙海 蒋丽 邱月棨 姚南 刘力聪 谢昱明 熊峰 谭思齐 匡琪琪 尤睿璇 柴可 罗鑫 龙浩君 忻悦 郭子瑜 王佳琪 谭怡忻 张庆 张桂英 李亚萍 苏玉文 肖嵘 陆前进 |
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| 作者单位： | 1中南大学湘雅二医院皮肤科中南大学皮肤性病研究所皮肤重大疾病与皮肤健康湖南省临床医学研究中心，长沙410011；2中国医学科学院、北京协和医学院皮肤病医院，南京210042 |
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| 基金项目： | “湖湘青年英才”支持计划项目（2018RS3031）；皮肤重大疾病与皮肤健康湖南省临床医学研究中心建设项目（2016SK4001）；湖南省高层次卫生人才“225”工程项目（2019-196）；长沙市杰出创新青年培养计划项目（kq1802002） |
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| 摘 要： | 目的:总结皮肤科病房危重症患者的临床特点及救治经验。方法:收集中南大学湘雅二医院皮肤科病房2011年7月9日至2020年12月31日期间收治的所有"病危"、"病重"患者，回顾其病历资料，总结疾病种类及构成比、主要并发症、病危/病重原因、重要救治措施及病情转归，对死亡病例进行死亡原因分析。结果:共收治危重症患者1 057...
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| 关 键 词： | 皮肤疾病 危重病 药疹 结缔组织疾病 皮肤疾病，水疱大疱性 感染 死亡原因 合并症 并发症 救治措施 |
| 收稿时间： | 2021-08-02 |
Clinical analysis of 1 057 patients with critical illnesses in a dermatological ward |
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| Long Hai,Jiang Li,Qiu Yueqi,Yao Nan,Liu Licong,Xie Yuming,Xiong Feng,Tan Siqi,Kuang Qiqi,You Ruixuan,Chai Ke,Luo Xin,Long Haojun,Xin Yue,Guo Ziyu,Wang Jiaqi,Tan Yixin,Zhang Qing,Zhang Guiying,Li Yaping,Su Yuwen,Xiao Rong,Lu Qianjin. Clinical analysis of 1 057 patients with critical illnesses in a dermatological ward[J]. Chinese Journal of Dermatology, 2021, 54(9): 790-797. DOI: 10.35541/cjd.20210549 |
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| Authors: | Long Hai Jiang Li Qiu Yueqi Yao Nan Liu Licong Xie Yuming Xiong Feng Tan Siqi Kuang Qiqi You Ruixuan Chai Ke Luo Xin Long Haojun Xin Yue Guo Ziyu Wang Jiaqi Tan Yixin Zhang Qing Zhang Guiying Li Yaping Su Yuwen Xiao Rong Lu Qianjin |
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| Affiliation: | 1Department of Dermatology, The Second Xiangya Hospital of Central South University, Institute of Dermatology and Venereology of Central South University, Hunan Clinical Medicine Research Center for Major Skin Diseases and Skin Health, Changsha 410011, China; 2Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China |
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| Abstract: | 【Abstract】 Objective To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward. Methods All patients with serious or life-threatening conditions，who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed. Results A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions （332 cases）, connective tissue diseases （226 cases）, bullous skin diseases （104 cases）, psoriasis （57 cases）, erythroderma （45 cases）, infectious skin diseases （67 cases）, etc. Among them, psoriasis （39 cases） and erythroderma （32 cases） mostly occurred in males, and connective tissue diseases （168 cases） mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit （ICU）, 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients （93.57%） achieved improvement and were discharged. A total of 14 patients （1.32%） died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively. Conclusions Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time. |
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| Keywords: | Skin disease Critical illness Drug eruptions Connective tissue diseases Skin diseases vesiculobullous Infection Cause of death Coexisting diseases Complications Treatment measures |
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