目的　比较 3种不同方案对小儿急性特发性血小板减少性紫癜的疗效。方法　 1989年 1月～ 1998年 10月采用肾上腺皮质激素口服、冲击治疗或大剂量静滴丙种球蛋白 (HDIVIG)等 3种方案对 66例急性ITP患儿进行 72例次治疗。结果　三组疗效差异无显著性。结论　作者认为对于轻型急性ITP患儿用激素口服法较适合 ;而对于病情重、经济承受力差者 ,则选用激素冲击疗法 ,用药期间应密切观察患儿血压、水电解质变化 ,及时处理高血压、低钾、低钠、低钙等电解质紊乱 ,并加强消化道粘膜的保护 ,同时注意防治感染。若病情重特别是合并感染者 ,而经济条件许可 ,宜首选HDIVIG +激素治疗 ,使用IVIG既可达到较快控制出血的目的 ,又有助于感染的控制 Objective To compare the curative effect of three different regimens on children with acute idiopathic thrombocytopenic purpura. Methods From January 1989 to October 1998, 66 patients with acute ITP were treated 72 times with oral adrenocorticotropic hormone, shock therapy or high dose intravenous gamma globulin (HDIVIG). Results There was no significant difference in efficacy between the three groups. Conclusion The authors believe that for children with mild acute ITP hormone therapy is more appropriate for oral administration; and for severe illness, poor economic affordability, the use of hormone therapy, medication should be closely observed in children with blood pressure, water and electrolyte changes, and timely treatment of hypertension , Low potassium, low sodium, low calcium and other electrolyte disorders, and to strengthen the protection of gastrointestinal mucosa, while preventing infection. If the condition is particularly serious with co-infection, and economic conditions permit, the preferred HDIVIG + hormone therapy, the use of IVIG can achieve the purpose of faster bleeding control, but also contribute to infection control