烧伤后并发金黄色葡萄球菌烫伤样皮肤综合征一例

患者烧伤后出现创面及全身感染较为多见,而并发金黄色葡萄球菌烫伤样皮肤综合征报道较少。该病多见于出生后1～5周的婴儿;成人罕见发病,且预后差,死亡率超过5 0 % [1] 。现将笔者单位2 0 0 2年5月收治的1例该类患者报道如下。患者男,6 6岁,被热水烫伤后1h入院。诊断:Ⅱ度烫伤,总面积4 0 %TBSA。入院后立即行抗休克、抗感染治疗。创面采用暴露疗法,外用烧烫宁喷剂(主要成分:牡丹皮、黄柏等,四川照金制药有限责任公司) ,患者平稳度过休克期。伤后4d患者出现畏寒、高热,体温4 0℃,颜面部潮红,躯干可见片状红斑,触痛敏感。伤后6d红斑逐渐蔓延…     

地塞米松治疗葡萄球菌性烫伤样皮肤综合症30例临床分析

为了探讨加用地塞米松治疗SSSS的疗效,应用静脉注射地塞米松对28例SSSS患者进行临床研究表明,地塞米松是辅助治疗SSSS较好的方法,能更快的控制皮损的面积和皮损的程度,达到快速缓解症状,缩短病程,提高治愈率.     

葡萄球菌烫伤样皮肤综合征患儿的护理

对24例葡萄球菌烫伤样综合征的患儿除采用常规护理外,尚使用0.25‰三氯异氰尿酸溶液对患儿皮损处进行浸泡、湿敷.结果患儿均痊愈,平均住院(7.8±0.9)d.提示通过科学有效的治疗与护理,可使葡萄球菌烫伤样综合征获得满意疗效.     

葡萄球菌性烫伤样皮肤综合征13例的临床观察及护理

葡萄球菌性烫伤样皮肤综合征(staphylococcal scalded skin syndrome,SSSS)是一种泛发性、融合性、浅表性、剥脱性皮肤病[1],主要发生于新生儿及6岁以下儿童,临床表现为发热、喉咙痛和皮肤明显触痛,Nikolsky征阳性,数小时至数天内出现表皮松弛的大疱,大片表皮剥脱,病情变化快,易并发支气管肺炎、脑膜炎、败血症等,死亡率高。由于红斑水疱首发于面部,给患儿家属造成恐惧、焦急心理,担心日后面部受损而影响面容。     

金葡菌性烫伤样皮肤综合征的护理

目的探讨金葡菌性烫伤样皮肤综合征的护理方法。方法2009-2010年收治3l例患儿,其中1-5岁25例,6-7岁6例。观察皮肤红斑触痛,眼及口周裂纹,红斑蔓延全身,发生松弛型大疱、皮肤剥脱、尼氏征阳性伴有发热,给予足量抗生素、激素及对症治疗并进行相应的护理。结果31例住院患儿经过7-14d有效治疗和精心护理,均痊愈康复出院。结论金葡菌性烫伤样皮肤综合征患者主要诊断准确,及时治疗有效护理是预防感染是关键措施。     

金葡菌性烫伤样皮肤综合症的护理体会

目的:探讨患儿的病情观察,护理措施,提高护理水平.方法:对20例金葡菌性烫伤样皮肤综合症患儿的皮肤黏膜、临床用药、病情变化、机体抵抗力、心理等方面密切观察,并采取积极的护理措施.结果:20例患儿全部痊愈,均未发生并发症.结论:准确有效的病情观察和细致周到的护理,可促进患儿创面早日愈合,有效减少并发症,降低死亡率.     

金黄色葡萄球菌肠毒素B单克隆抗体对烫伤脓毒症大鼠急性肺损伤的影响

目的探讨金黄色葡萄球菌(简称金葡菌)肠毒素B(SEB)单克隆抗体(单抗)对烫伤脓毒症大鼠急性肺损伤的保护作用。方法雄性Wistar大鼠56只随机分为正常对照组(n=10)、烫伤对照组(n=10)、烫伤后金葡菌感染组(n=20)和SEB单克隆抗体(单抗)拮抗组(n=16)。测定肺组织SEB水平、髓过氧化物酶(MPO)活性、肿瘤坏死因子(TNF)-α和干扰素(IFN)-γ表达的改变。结果烫伤后金葡菌脓毒症动物肺脏SEB含量明显升高,伤后2、6h分别为66.85ng/g组织和92.46ng/g组织,与正常对照组(14.26ng/g组织)和烫伤对照组(17.32ng/g组织)相比均为P＜0.01;同时,肺组织MPO活性显著增强,峰值可达7.39U/g组织,与正常对照组(2.09U/g组织)相比P＜0.05。与之相应,肺组织MPO活性显著增强(P<0.05)。同时,局部组织IFN-γ和TNF-α基因及其蛋白质表达明显上调(P<0.05),并与肺脏SEB含量呈高度正相关(分别为r=0.9207、P=0.0033和r=0.8142、P=0.0258)。SEB单抗早期干预可有效降低肺组织中SEB含量,并显著抑制IFN-γ和TNF-α的产生,肺脏病理改变亦明显减轻。结论SEB单抗干预可抑制IFN-γ和TNF-α等炎症介质的产生,从而显著减轻烫伤后金葡菌对机体的损害。     

11例外伤性金黄色葡萄球菌败血症诊治分析

目的 探讨外伤性金黄色葡萄球菌败血症的诊断及防治措施.方法 回顾性分析本院2011年1月至2012年10月收治的11例因轻微锐物刺伤或割伤引起的外伤性金黄色葡萄球菌败血症患者的临床资料.结果 结论 金黄色葡萄球菌可在皮肤屏障受损后引起严重感染.作好劳动防护及意外受伤后及时有效处理伤口是避免金黄色葡萄球菌机会性感染的有效手段.详细询问病史及体检结合血常规结果 可有利于本病的诊断.当抗菌药物治疗效差时宜注意有否隐匿性迁徙性病灶的存在.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

目的 观察金黄色葡萄球菌(SA)侵袭烫伤家兔后淋巴细胞蛋白质组的变化.方法 将24只家兔按随机数字表法分为对照组、烫伤组、sA侵袭2 h组、sA侵袭6 h组,每组6只.对照组家兔37℃模拟烫伤;其余3组家兔均造成背部30%TBSAⅢ度烫伤,SA侵袭2、6 h组分别于伤后18、22 h经耳缘静脉注射2 mL(1.0×108CFU/mL)对数生长期sA悬液.4组家兔致伤后24 h取颈动脉血分离获取淋巴细胞,提取细胞总蛋白,进行双向凝胶电泳和质谱分析.结果 4组家兔淋巴细胞平均蛋向质点数约为1030个;与对照组比较,其余3组筛选出差异蛋白质点19个,1鉴定了其中11个蛋白质点,包括10种蛋白质.表达下调的蛋白质有丝切蛋白、胞溶质蛋白A、泛素、核苷二磷酸激酶、,奋氨酸脱氢酶和膜联蛋白1,而过氧化物氧化还原素表达明显上调.结论 家兔烫伤后或烫伤+SA侵袭后淋巴细胞蛋白质组发生了明显变化,这可能与伤后免疫抑制和脓毒症的发生有关.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.