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1992～1995年,我们收治重症水痘患者17例,其中15例系因病初在基层医院应用糖皮质激素所致。患者年龄5～18岁,发病3～6天入院。12例肌注或静滴地塞米松(10～35mg),3例静滴氢化可的松(100～300mg)。其中出血性水痘6例,大疱性水痘1例,皮疹化脓感染脓毒血症3例,水痘性脑炎、原发性水痘肺炎各2例,心肌炎1例。本组经皮肤局部处理及全身综合性治疗,均治愈,平均住院14.5天。 体会:本组患者均因发热应用激素降温而致病情加重。由于部分基层医务人员对激素引起的不良后果缺乏足够的认识(尤其对水痘患者),故造成盲目滥用。在对本组患者的治疗过程中,我们体会:①加强皮肤护理,促进疱疹结痂,对防止继发感染颇为重要。②对病程长、体弱、消化道痘疹明显者,给予鼻饲、支持疗法,有利于改善病情。③干扰素不失为理想的抗病毒药物。④输新鲜全血可加速病情好转,改善预后;早用、小量、多次输新鲜血可缩短病
From 1992 to 1995, we treated 17 cases of severe chickenpox patients, of which 15 cases were due to the early application of glucocorticoid in primary hospitals. Patients aged 5 to 18 years old, the incidence of 3 to 6 days admission. 12 cases of intramuscular injection or intravenous dexamethasone (10 ~ 35mg), 3 cases of intravenous hydrocortisone (100 ~ 300mg). Among them, 6 cases of hemorrhagic chickenpox, 1 case of bullous chickenpox, 3 cases of sepsis with purulent septicemia, 2 cases of varicella encephalitis, 2 cases of primary varicella pneumonia and 1 case of myocarditis. This group of local treatment of skin and systemic treatment, were cured, the average hospital stay 14.5 days. Experience: This group of patients are due to fever and hormones caused by the deterioration of the disease. Due to the lack of adequate knowledge of the adverse effects caused by hormones (especially for chickenpox patients), some grassroots medical staff have caused blind abuse. In the treatment of patients in this group, we experience: ① strengthen the skin care and promote scab herpes, to prevent secondary infection is quite important. ② on the long course, weak, obvious diarrhea, smallpox, nasal feeding, supportive therapy, help to improve the condition. ③ interferon is an ideal antiviral drug. ④ lose fresh whole blood can accelerate the improvement of the condition, improve the prognosis; early use, small amount, repeatedly lose new blood can shorten the disease