儿童腹型过敏性紫癜临床及内镜特征

发布时间：2018-06-14 17:45

本文选题：过敏性紫癜 + 内镜表现　；参考：《临床儿科杂志》2017年10期

【摘要】：目的探讨儿童腹型过敏性紫癜(HSP)的临床表现、内镜改变及病理组织学特点。方法回顾分析2011年6月至2016年6月住院治疗的151例以腹痛为首发主要表现的HSP患儿的临床资料。结果 151例HSP患儿,男87例、女64例,年龄4.8~11.5岁。所有患儿均有腹痛,皮肤紫癜100例(66.22%)、呕吐72例(47.68%)、呕血59例(39.07%)、便血44例(29.13%),伴关节肿痛8例(5.29%)。114例(75.49%)外周血白细胞增高、48例(31.78%)C反应蛋白升高、21例(13.90%)白蛋白降低。49例(32.45%)患儿B超示局限性肠壁增厚。96例患儿行胃镜检查,主要表现为,点片状出血、红斑89例(92.70%),糜烂或溃疡伴出血68例(70.83%),淤斑37例(38.54%),血肿样突起13例(8.60%);十二指肠降部病变最常见且最严重,其次为胃窦部、十二指肠球部。病理组织学呈毛细血管炎表现37例,伴幽门螺杆菌感染10例。55例患儿行肠镜检查,主要表现为点片状出血、红斑49例(89.09%),糜烂或多发溃疡伴出血27例(49.09%);回肠末端病变最常见且最严重,其次为直肠。结论儿童腹型HSP的临床表现多样,常累及十二指肠降部、回肠末端,内镜检查对儿童腹型HSP诊断有价值。
[Abstract]:Objective to investigate the clinical manifestations, endoscopic changes and histopathological features of abdominal Henoch-Schonlein purpura (HSPs) in children. Methods the clinical data of 151 patients with HSP who were hospitalized from June 2011 to June 2016 were retrospectively analyzed. Results 151 patients with HSP, 87 males and 64 females, aged from 4.8 to 11.5 years old. All the children had abdominal pain. 100 cases with purpura, 72 cases with vomiting, 47.68, 59 with hematemesis, 29.1313 with hematemesis, 44 with articular swelling and pain, 8 with articular swelling and pain, with 75.49) with leukocytosis in peripheral blood of 48 patients with elevated serum leucocyte count in 21 patients with elevated C-reactive protein (21 with 13.90) albumin decrease in 49 patients with reduced albumin (32.4545) Thickening. 96 cases of children underwent gastroscopy, The main manifestations were as follows: spot hemorrhage, erythema in 89 cases (92.70%), erosion or ulcer with hemorrhage in 68 cases (70.83), stasis in 37 cases (38.54), hematoma like protuberance in 13 cases (8.60D), duodenal descending lesion in the most common and serious part, gastric antrum and duodenal bulbar in the second place. Histopathology showed capillary inflammation in 37 cases and helicobacter pylori infection in 10 cases. 55 cases were examined by enteroscopy. There were 49 cases of erythema and 49 cases of erythema, 27 cases of erosion or multiple ulcers with bleeding, and the most common and serious lesions of ileum terminal, followed by rectum. Conclusion the clinical manifestations of abdominal type HSP in children are various, often involving the descending part of duodenum and the terminal ileum. Endoscopy is valuable for the diagnosis of abdominal type HSP in children.
【作者单位】：郑州儿童医院消化内科;
【分类号】：R725.5

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