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目的:讨论小儿过敏性紫癜的病因、临床表现、治疗、尽早确诊,减少误诊。方法:对我科1995年—2009年收治的腹型性紫癜患儿45例,其中误诊19例进行分析。结果:大多数患儿主要表现为反复出现的皮疹、腹痛、关节痛、尿检查异常,本组误诊急性肠炎6例,急性出血性肠炎4例,肠道蛔虫病3例,肠套叠2例,急性阑尾炎2例,消化道溃疡1例,肠系膜淋巴结炎1例。结论:单纯皮肤紫癜诊断并不困难,而先天皮肤紫癜出现消化道症状、关节症状、皮肤血管神经水肿者仍易导致误诊。大部分预后良好,部分可病情反复、迁延甚至肾功能损害。
Objective: To discuss the etiology, clinical manifestations and treatment of children with Henoch-Schonlein purpura and to diagnose as soon as possible to reduce misdiagnosis. Methods: 45 cases of abdomen purpura were treated in our department from 1995 to 2009, of which 19 cases were misdiagnosed for analysis. Results: Most of the children showed recurrent rash, abdominal pain, arthralgia and urine abnormalities. The group misdiagnosed 6 cases of acute enteritis, 4 cases of acute hemorrhagic enteritis, 3 cases of intestinal ascariasis, 2 cases of intussusception , 2 cases of acute appendicitis, 1 case of peptic ulcer and 1 case of mesenteric lymphadenitis. Conclusion: The diagnosis of pure skin purpura is not difficult, but the innate skin purpura gastrointestinal symptoms, joint symptoms, skin and blood vessel nerve edema are still easily lead to misdiagnosis. Most of the prognosis is good, some may be repeated illness, delay and even renal dysfunction.