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目的随访川崎病(KD)患儿冠状动脉损害的变化及护理配合。方法护理全程配合用彩色多普勒超声心动图检查KD患儿,对伴冠状动脉损害者进行随访,在恢复期用三磷腺苷负荷超声心动图检查,观察冠状动脉损害、扩张、瘤的变化差异。结果 356例KD患者,其中147例检出有冠状动脉损害,占41.3%,99例冠状动脉扩张,占27.8%,48例冠状动脉瘤,占13.5%(中小型冠状动脉瘤37例,巨大型冠状动脉瘤11例)。对119例冠状动脉损害患儿定期门诊随访2年,仍有19例患儿存在冠状动脉损害;冠状动脉扩张的患儿冠状动脉管径均回缩至正常;中小型冠状动脉瘤的28例患儿,冠状动脉管径均回缩至正常,巨大型冠状动脉1例冠状动脉管径仍>8mm(较急性期略缩小),7例转为中小型冠状动脉瘤,3例转为冠状动脉管径扩张,管壁增厚,其中1例并发冠状动脉开口狭窄(经冠状动脉造影证实)。结论 KD患儿急性期冠状动脉扩张损害为一过性;大部分中小型冠状动脉瘤改变可恢复;巨大型冠状动脉瘤的损害可长期存在。超声心动图和三磷腺苷负荷超声心动图对追踪观察KD冠状动脉损害的变化及心肌供血有重要帮助,门诊随访需要良好的护理配合。
Objective To investigate the changes of coronary artery lesion in children with Kawasaki disease (KD) and their nursing cooperation. Methods Nursing full cooperation with color Doppler echocardiography in children with KD, were accompanied by coronary artery lesions were followed up in the recovery period with adenosine triphosphate load echocardiography, coronary artery damage, expansion, changes in the tumor difference. Results Of the 356 patients with KD, 147 (41.3%) had coronary lesion detected, 99 (82%) had coronary artery dilatation, accounting for 27.8% (48%), accounting for 13.5% (37 for small and medium sized coronary aneurysms, Coronary aneurysm in 11 cases). A total of 119 cases of coronary artery lesions in children with regular follow-up of 2 years, there are still 19 cases of children with coronary artery lesions; coronary artery diameter in children with coronary artery diameter were reduced to normal; 28 cases of small and medium-sized coronary aneurysms The diameter of coronary artery in both children and children were all reduced back to normal. One patient with giant coronary artery still had a diameter of> 8mm (slightly smaller than that of acute coronary artery), 7 patients were converted to small and medium sized coronary aneurysm, and 3 patients received coronary artery Diameter expansion, thickening of the wall, including 1 case of coronary stenosis (confirmed by coronary angiography). Conclusions Coronary artery dilatation and injury in acute KD are transient. Most of the small and medium sized coronary aneurysms can be recovered. The damage of giant coronary aneurysm can be long-term. Echocardiography and adenosine triphosphate load echocardiography to track changes in KD coronary artery lesions and myocardial blood supply is an important help, out-patient follow-up need good care and cooperation.