儿童过敏性紫癜外科并发症的诊断和治疗

来源 :南京医科大学学报(自然科学版) | 被引量 : 0次 | 上传用户:bluesnail2002
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目的:分析探讨儿童过敏性紫癜外科并发症的诊断和治疗。方法:对14例本院的有外科并发症的过敏性紫癜患儿的诊断和治疗经过(包括:临床特点、典型皮疹的例数、B超及X线表现、外科手术所见、治疗结果及预后)进行回顾性分析。结果:所有14例患儿均以腹痛为首发症状,出现典型皮肤紫癜11例(78.6%),其中肠套叠4例,肠梗阻5例,自发性肠穿孔2例,胆囊水肿2例,阑尾脓肿1例。予解痉、抗过敏,辅以抑酸、对症治疗。对于腹痛仍难以缓解者加用氢化可的松5~l0mg/(kg·d)静滴,症状消失后可改用强的松口服,总疗程为2~3周。其中手术治疗9例(64.3%),手术中均见浆膜下广泛出血点,部分融合成片。全部14例均临床治愈。结论:过敏性紫癜的外科并发症多样,在出现外科并发症而保守治疗无效时应尽早手术探查,以使患儿尽快恢复和降低病死率。 Objective: To analyze and discuss the diagnosis and treatment of surgical complications of children allergic purpura. Methods: The diagnosis and treatment of 14 cases of Henoch-Schonlein purpura with surgical complications in our hospital were reviewed (including clinical features, the number of typical rashes, B- and X-ray findings, surgical findings, and Prognosis) for retrospective analysis. Results: In all 14 cases, abdominal pain was the first symptom. Eleven cases (78.6%) of typical skin purpura appeared, including 4 cases of intussusception, 5 cases of intestinal obstruction, 2 cases of spontaneous intestinal perforation, 2 cases of gallbladder edema, Abscess in 1 case. To antispasmodic, anti-allergy, supplemented by acid, symptomatic treatment. For abdominal pain is still difficult to alleviate those with hydrocortisone 5 ~ l0mg / (kg · d) intravenous infusion, the symptoms can be changed to prednisone oral, the total course of treatment is 2 to 3 weeks. Among them, 9 cases (64.3%) were treated surgically, with extensive subserosal hemorrhage and partial fusion into tablets. All 14 cases were clinically cured. Conclusion: There are many surgical complications of anaphylactoid purpura. Surgical exploration should be carried out as early as possible in the event of surgical complications and conservative treatment, so as to make the patients recover and reduce the mortality rate as soon as possible.
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