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目的探讨小儿川崎病的临床特点,提高诊治水平。方法采用回顾性分析的方法,对48例川崎病患儿的临床表现、实验室辅助检查及治疗效果进行临床分析。结果典型川崎病34例,非典型川崎病14例.对早期诊断具有提示价值的有发热、眼球结膜充血、唇红干裂、口腔黏膜表现、皮疹、指(趾)端硬肿,其中以发热(100%)、结膜充血(75.0%)、唇红干裂(93.8%)最常见.肛周皮肤脱皮、卡瘢红对川崎病特异性较高,可列为参考诊断指标之一。川崎病发病早期就可发现冠状动脉病变,单剂丙种球蛋白(IVIG)1g/kg+阿司匹林治疗效果好,发生冠状动脉改变17例,对其中15例(3例失访)随访半年,冠状动脉内径均恢复正常。结论早期诊断、早期大剂量应用丙种球蛋白静脉滴注辅以抗凝治疗,是防止冠状动脉病变、减轻临床症状、提高治愈率的有效手段。
Objective To investigate the clinical features of pediatric Kawasaki disease and to improve the diagnosis and treatment. Methods A retrospective analysis of 48 cases of children with Kawasaki disease clinical manifestations, laboratory tests and treatment of clinical effects. Results Of the typical Kawasaki disease in 34 cases, atypical Kawasaki disease in 14. Early diagnosis has prompted the value of fever, conjunctival hyperemia, lip red chapped, oral mucosa, rash, finger toe side sclerosis, which fever ( 100%), Conjunctival hyperemia (75.0%) and cleft lip redness (93.8%) are the most common ones. Perianal skin peeling and card scar are highly specific to Kawasaki disease and may be cited as one of the reference diagnostic criteria. In the early stage of Kawasaki disease, coronary artery lesion was found. Single-dose IVIG 1g / kg + aspirin treatment was effective and 17 cases of coronary artery changes occurred. Fifteen patients (3 patients lost follow-up) were followed up for 6 months. The diameter of coronary artery All returned to normal. Conclusion Early diagnosis, early high-dose gamma globulin intravenous infusion combined with anticoagulant therapy is to prevent coronary artery disease, reduce clinical symptoms and improve the cure rate of effective means.