口底多间隙感染合并多脏器功能不全综合征一例

口底多间隙感染又称口底蜂窝组织炎,曾是口腔颌面部间隙感染中最严重而治疗最困难的炎症之一^[1],随着诊疗水平的提高及抗生素的合理应用,本病已很少见,近期北京天坛医院急诊科成功救治1例口底多间隙感染致多脏器功能不全综合征（muhiple organ dysfunction syndrome,MODS）,现报告如下。     

史蒂文斯-约翰逊综合征合并肝功能不全1例的治护体会

本文回顾了1例重症多形红斑型药疹[史蒂文斯-约翰逊综合征(SJS)]合并肝功能不全的治护经验.由于本病起病急、进展快,皮损严重,极易感染,严重者危及生命,医护人员针对性制定一套包括一般情况护理、皮损黏膜护理、心理护理、中医护理、饮食护理在内的整体护理方案协助治疗,减少了并发症和感染的发生,患者好转出院.     

重症多形红斑型药疹4例的护理体会

目的：探讨重症多形红斑型药疹的有效护理。方法：①停可疑药物,给予适量激素治疗;②预防感染;③皮肤和黏膜护理（皮肤、眼部、鼻腔、口腔、会阴部等）;④饮食营养护理;⑤心理护理;⑥静脉输液的护理：⑦高热护理。结果：采用上述护理措施对重症多形红斑型药疹实施全面的整体护理,4例患者治愈出院。结论：重症药疹患者早期及时治疗及实施综合有效的护理措施,可缩短病程,提高治愈率,降低死亡率。     

多器官功能不全综合征动物模型的建立及其血流动力学变化

目的 探讨建立多器官功能不全综合征（MODS）动物模型并观察其血流动力学变化的可能性。方法标准大肠杆菌缓慢注入16只雄性健康小香猪的右侧颈内静脉,注入前及注入后1h、3h、5h、7h用Swan—Ganz氏漂浮导管检测其血流动力学指标：心输出量（CO）,心脏每搏输出量指数（SVI）,左室每搏功指数（LVSWI）,肺毛细血管楔压（PAWP）,心脏指数（CI）,体循环阻力指数（SVRI）,记录其平均动脉压（MAP）。结果注入大肠杆菌后,这些血流动力学指标的变化可分3期。注入大肠杆菌即刻至1h进入低排高阻期,MAP、CI、SVI和LVSWI均显著低于制模前,而SVRI显著高于制模前（均P〈0．05）。注入大肠杆菌后3—5h为高排低阻期,MAP、SVRI降低;CI略升高,但与制模前无显著性差异。7h后为低排低阻期,MAP、CI、SVRI、LVSWI均进行性降低（均P〈0．05）。注入大肠杆菌1h后动物模型PAWP一直显著高于制模前水平（均P〈0．05）。结论建立了标准的MODS动物模型,可用漂浮导管系统观察MODS发病过程中各个时期的血流动力学变化,以为MODS的临床研究提供实验基础。     

何杰氏淋巴瘤合并药疹1例

患者女 ,5 5岁 ,因全身反复出现红色丘疹及斑丘疹伴发热 2月 ,淋巴结肿大 1月于 1998年 3月 2 0日入院。患者于入院前 2月无明显诱因出现发热。体温波动于 38℃左右。服用青霉素Ｖ钾片、克感敏等药物后 ,双下肢出现丘疹 ,斑丘疹 ,并逐渐波及至全身 ,皮疹密集对称分布 ,伴瘙痒 ,在当地用抗组胺药治疗后皮疹消退。但仍持续发热 ,又给氨苄青霉素、氯霉素抗炎治疗。全身又出现密集对称分布针头至米粒大小的红色丘疹及斑丘疹 ,瘙痒剧。在县医院给上述抗过敏治疗后皮疹再次消退。体温仍波动于 38℃～ 39℃之间。同时伴有乏力 ,纳差 ,消瘦 ,并发现…     

1例大疱性表皮松解型药疹的护理体会

1　临床资料患者 ,男 ,2 2岁 ,因全身皮肤起弥漫性紫红色斑、水疱并持续高烧 40℃以上 3日入院。患者于 18日前因前颅骨骨折 ,曾住某医院给予静滴先锋霉素Ｖ、肌注ＶＢ1、ＶＢ12 ,口服卡马西平等治疗。 15天后患者感双手掌疼痛 ,面部起丘疹 ,双眼视物模糊 ,口唇肿胀。面部及全身皮肤散在发生紫色斑 ,并出现水疱 ,发热。曾诊为“水痘”、“川崎病”等治疗无效。于 1999年 12月 2 8日 5ｐｍ转入我院。查体 :一般情况差 ,神志清 ,面部肿胀 ,紫红色斑。结膜充血 ,伴大量脓性分泌物 ,睁眼困难。口腔粘膜糜烂 ,口唇干裂、肿胀 ,语言模糊不清。鼻腔…     

注射维生素K1致多型红斑型药疹1例

临床资料患者,女,34岁。主因双臀部红斑伴瘙痒9天,面、颈、躯干、四肢斑丘疹伴瘙痒4天,于2010年5月2日来我科就诊。20天前,患者因功能性子宫     

慢性非传染性疾病对老年与非老年急性脑梗死患者发生多器官功能不全综合征的影响对照研究

目的分析慢性非传染性疾病对急性脑梗死患者发生多器官功能不全综合征（MODS）的影响。方法将864例急性脑梗死患者分为两组：老年组（n=594）[平均年龄（71．39±6．70）岁（60-94岁）]，和非老年组（n=270）[年龄（49．58±8．34）岁（18-59岁）]。老年组发生MODS154例（25．9％），非老年组发生MODS39例（14．4％）。将可能对急性脑梗死患者MODS的发生产生影响的慢性非传染性疾病进行多因素Logistic回归分析，寻找其中的危险因素。结果在老年组，慢性非传染性疾病中糖尿病、高血压、心血管慢性病、呼吸系统慢性病、肾脏慢性病是急性脑梗死患者多器官功能不全综合征发生的主要危险因素；在非老年组，高血压、心血管慢性病是主要危险因素。结论老年组的慢性基础病和多器官功能衰竭的发生率高于非老年组。不同年龄组的脑梗死患者发生MODS的主要危险因素不完全相同。     

多力玛结合人绒毛膜促性腺激素治疗黄体功能不全引起先兆流产的疗效

目的探讨多力玛结合人绒毛膜促性腺激素治疗黄体功能不全引起先兆流产的疗效。方法随机选取2014年5月至2017年5月西安高新医院诊治的黄体功能不全引起先兆流产的106例患者为研究对象。依据治疗方法将这些患者分为多力玛结合人绒毛膜促性腺激素治疗组(结合治疗组,53例)和单独人绒毛膜促性腺激素治疗组(单独治疗组,53例)两组,对两组患者的HCG、E2、P水平、临床疗效、不良反应发生情况进行统计分析。结果两组患者治疗后6周、7周、8周、9周的HCG、E2、P水平均逐渐提升,差异具有统计学意义(P0.05);治疗后8周结合治疗组患者的P水平显著低于单独治疗组,差异具有统计学意义(P0.05)。结合治疗组患者治疗的总有效率94.3%(50/53)显著高于单独治疗组73.6%(39/53),差异具有统计学意义(P0.05),但两组患者的不良反应发生率22.6%(12/53)、18.9%(10/53)之间的差异无统计学意义(P0.05)。结论多力玛结合人绒毛膜促性腺激素治疗黄体功能不全引起先兆流产的疗效较人绒毛膜促性腺激素治疗显著。     

头孢哌酮舒巴坦钠致重症多形红斑型药疹合并肝损害1例

重症多形红斑是一种严重的大疱性多形红斑,伴有严重的全身反应,并有眼、口、生殖器黏膜损害,大部分与药物有关,现临床报道我院收治的由头孢哌酮舒巴坦钠引起的重症多形红斑型合并肝损害1例。     

Generalized Lichenoid Drug Eruption Associated with Imatinib Mesylate Therapy

Imatinib mesylate (IM), an anticancer drug, has been widely used to treat chronic myeloid leukemia (CML), gastrointestinal stromal tumors (GIST), and dermato-fibrosarcoma protuberans. Cutaneous reactions to IM have been reported to occur in varying number of patients in different case series. Non-lichenoid cutaneous reactions secondary to IM have been well-documented in the literature and are the commonest non-hematologic adverse reactions associated with its use. Lichenoid drug eruption (LDE) associated with IM therapy has rarely been reported in the literature. A case of a generalized LDE associated with IM therapy has been described here for its rarity and interesting clinical presentation. As the clinical usage of IM is increasing, one might expect an increasing number of similar patients in the future. It is thus important to realize the potential of IM to produce LDE and to differentiate this entity from idiopathic lichen planus. In the present article, the reports of IM-associated LDE, described in the PubMed and Medline database (in English language literature), have also been reviewed.     

运用人类基本需要理论护理重度药疹患者1例

以人类基本需要缺陷的种类及程度 ,确立护理诊断、目标和措施 ,探讨人类基本需要理论在整体护理中的作用和效果。提示依人类基本需要理论为基础 ,对 1例重度药疹患者进行整体护理 ,根据病后患者基本需要理论指导临床护理 ,可提高整体护理水平     

A Case Report of Pirfenidone-Induced Lichenoid Drug Eruption in a Patient with Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and lethal lung disease characterized by progressive dyspnea and irreversible loss of lung function. Pirfenidone is a novel anti-fibrotic and anti-inflammatory drug, which reduces deterioration in the lung function and prolongs progression-free survival in patients with IPF. However, it has adverse effects including gastrointestinal symptoms, hepatic dysfunction or skin photosensitivity, and rash. Lichenoid drug eruption (LDE) refers to lichen planus-like drug eruption usually presenting symmetric eczematous plaques with a purple hue. To date, numerous cases of LDE due to various drugs and pirfenidone-associated photosensitivity have been reported. However, a case of pirfenidone-induced LDE has been very rarely reported to our knowledge. Herein, is a case of pirfenidone-induced LDE so that clinicians can be aware of the possibility of LDE when using pirfenidone.     

Pustular Drug Eruption Due to Bacampicilin Hydrochloride in a Patient with Psoriasis

We report a case of pustular drug eruption due to bacampicilin hydrochloride which developed in a patient with pustular psoriasis. The patient was a 45-year-old Japanese woman with psoriasis which started as pustular psoriasis twenty years previously. In 1994, she developed generalized erythema with pustules accompanied by high fever and liver injury. Clinical and histological findings of this pustular eruption were different from her previous episodes of pustular psoriasis. Erythemas and pustules disappeared and her abnormal transaminase returned to normal rapidly when she discontinued bacampicilin hydrochloride. Her positive reaction to a patch test and a lymphocyte stimulation test also suggested that our case had a pustular drug eruption rather than pustular psoriasis induced by a drug.     

Asymptomatic Primary Sjögren's Syndrome in a Patient with Penicillin Drug Eruption

A 20-year-old woman visited our clinic because of acral numbness and skin eruptions after administration of oral penicillin. Serological tests revealed an increase of immunoglobulins (G & M), positive rheumatoid factor, anti-nuclear factor, anti-SSA and -SSB antibodies. Ophthalmologic and otolaryngological studies were consistent with those of Sjögren's syndrome. However, a skin biopsy specimen failed to show any specific changes for Sjögren's syndrome and the diagnosis of penicillin drug eruption was considered to be more preferable. We briefly discussed the coexistence of a drug allergy and asymptomatic connective tissue disease.     

扁平苔藓样药疹1例

患者男,77岁。全身出现红斑和丘疹,伴瘙痒7天。2个月前,患者口服"厄贝沙坦、美托洛尔、苯磺酸氨氯地平片、阿托伐他汀钙、阿司匹林、硫酸氯吡格雷、埃索美拉唑镁肠溶片"等药物。7天前,全身出现散在分布的粟粒至蚕豆大红斑和丘疹,以躯干和四肢近心端为著,瘙痒剧烈。既往无药物过敏史。左小腿胫前新鲜水疱组织病理示:表皮角化过度,棘层肥厚,基底细胞空泡样变性,真皮浅层以淋巴细胞为主的带状浸润,可见嗜酸性粒细胞及胶样小体。诊断:扁平苔藓样药疹。     

428例药疹临床分析

目的：了解药疹的主要临床特征及常见的致敏药物。方法：收集1998年10月～2003年10月确诊为药疹的病例428例，并对其发病年龄、主要致敏药物、皮疹类型等临床特征进行分析。结果：药疹的发病年龄有所提高，主要致敏药物以抗生素最常见，其次为解热镇痛抗炎药、生物制品、抗痛风药、抗癫痫药及中成药等。皮疹类型以麻疹样或猩红热样型最常见，其次为荨麻疹型、固定型、多形红斑型等，抗痛风药和抗癫痫病药多引起重症药疹。结论：引起药疹的主要致敏药物的种类已发生变化，抗生素已上升为药疹致病药物中的首位。