摘要
目的总结分析职业性三氯乙烯药疹样皮炎并发症及其影响因素。方法回顾性分析我院1997～2011年收治的186例职业性三氯乙烯药疹样皮炎患者的临床资料结果 1)186例中有173例发生并发症,占93.0%,前三位分别为电解质紊乱(78.5%,146/186)、感染(61.3%,114/186)、眼部并发症(30.6%,57/186);其次为贫血(19.9%,37/186)、糖尿病(19.4%,36/186)、药疹(18.8%,35/186)、低血糖(18.8%,35/186)、出血(18.3%,34/186)、血小板减少(17.2%,32/186)等。多因素逐步logistic回归分析显示,这与激素的不当使用相关,而激素总量是发生感染、电解质紊乱、五官科并发症的独立危险因素,冲击治疗是出血的独立危险因素,冲击治疗、首次剂量是糖尿病发生的独立危险因素。2)186例病例病死率为7.5%(14/186),其中急性肝衰竭9例、重症感染4例和高坠死亡1例。结论职业性三氯乙烯药疹样皮炎并发症发生率较高,并常为致死原因。规范的激素治疗及对并发症的正确、及时诊断,有助于降低病死率。
Objective In order to improve the treatment of the medicamentosa-like dermatitis cases caused by occupational trichloroethylene exposure , the complications of these cases and their potential affecting factors were summarized and analyzed. Methods Clinical data of 186 hospitalized cases from 1997 to 2011 were collected and analyzed. Results Complications were found among 173 cases （93%, 173/186）, and the complications, in the order of frequency, were ： electrolyte disturbances （78.5%, 146/186 ）, secondary infections （ 61.3%, 114/186 ）, ocular lesions （ 30.6%, 57/186 ）, anemia （ 19.9%, 37/186 ）, diabetes mellituses （ 19.4,36/186 ）, drug eruptions （ 18.8%, 35/186）, hypoglycemia （ 18.8%, 35/186 ）, bleedings （ 18.3%, 34/186） and thrombocytopenia （17.2% ,32/186）. The stepwise logistic regression analysis showed that：l） there was a correlation between occurrence of complications and the improper therapy of glucoeorticoid;2） the total dosage of glucocortieoid was an independent risk factor for secondary infections,electrolyte disturbances and ENT lesions;3） pulse glucocortieoid therapy was an independent risk factor for bleedings; 4） both the pulse therapy and the first dosage of glucocortieoid were the independent risk factors for diabetes mellitus. The fatality rate of these cases was 7.5 % （14/186）,9 cases due to acute hepatic failure,4 cases due to severe infection and 1 due to fall injury. Conclusion The incidence of complications of these disease was high,which would be the leading cause of death among these cases. Standardized glucocorticoid therapy as well as the correct and timely diagnosis of the complications contributed to reduce the fatality of the disease.
出处
《职业卫生与应急救援》
2012年第5期225-230,共6页
Occupational Health and Emergency Rescue
基金
广东省医学科研基金项目(项目编号:WSTJJ20081111210702196705250243)
关键词
职业性三氯乙烯药疹样皮炎
并发症
影响因素
Medicamentosa-like dermatitis caused by occupational trichloroethylene exposure
Complication
Affecting factors
