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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 To summarize and analyze the occupational trichlorethylene eruption-like dermatitis complications and its influencing factors. Methods The clinical data of 186 patients with occupational trichlorethylene eruption-like dermatitis treated in our hospital from 1997 to 2011 were retrospectively analyzed. Results 1) Of the 186 patients, 173 patients had complications (93.0%), the first three were electrolyte disturbances (78.5%, 146 of 186), infection (61.3%, 114 of 186) and ocular complications (30.6%, 57 of 186), followed by anemia (19.9%, 37 of 186) / 186), drug eruption (18.8%, 35 of 186), hypoglycemia (18.8%, 35 of 186), hemorrhage (18.3%, 34 of 186) and thrombocytopenia (17.2%, 32 of 186). Multivariate stepwise logistic regression analysis showed that this was related to the improper use of hormones, and the total amount of hormones was an independent risk factor for infection, electrolyte disturbance and ENT complications. Impact therapy was an independent risk factor for bleeding. Impact therapy, first dose Is an independent risk factor for diabetes. 2) The case fatality rate of 186 cases was 7.5% (14/186), including 9 cases of acute liver failure, 4 cases of severe infection and 1 case of high mortality. Conclusion The incidence of occupational trichlorethylene eruption-like dermatitis is high and often causes of death. Standardized hormone therapy and complications of the correct and timely diagnosis, help to reduce mortality.