本文選題：過(guò)敏性紫癜 + 內(nèi)鏡表現(xiàn)　； 參考：《臨床兒科雜志》2017年10期

【摘要】：目的探討兒童腹型過(guò)敏性紫癜(HSP)的臨床表現(xiàn)、內(nèi)鏡改變及病理組織學(xué)特點(diǎn)。方法回顧分析2011年6月至2016年6月住院治療的151例以腹痛為首發(fā)主要表現(xiàn)的HSP患兒的臨床資料。結(jié)果 151例HSP患兒,男87例、女64例,年齡4.8~11.5歲。所有患兒均有腹痛,皮膚紫癜100例(66.22%)、嘔吐72例(47.68%)、嘔血59例(39.07%)、便血44例(29.13%),伴關(guān)節(jié)腫痛8例(5.29%)。114例(75.49%)外周血白細(xì)胞增高、48例(31.78%)C反應(yīng)蛋白升高、21例(13.90%)白蛋白降低。49例(32.45%)患兒B超示局限性腸壁增厚。96例患兒行胃鏡檢查,主要表現(xiàn)為,點(diǎn)片狀出血、紅斑89例(92.70%),糜爛或潰瘍伴出血68例(70.83%),淤斑37例(38.54%),血腫樣突起13例(8.60%);十二指腸降部病變最常見且最嚴(yán)重,其次為胃竇部、十二指腸球部。病理組織學(xué)呈毛細(xì)血管炎表現(xiàn)37例,伴幽門螺桿菌感染10例。55例患兒行腸鏡檢查,主要表現(xiàn)為點(diǎn)片狀出血、紅斑49例(89.09%),糜爛或多發(fā)潰瘍伴出血27例(49.09%);回腸末端病變最常見且最嚴(yán)重,其次為直腸。結(jié)論兒童腹型HSP的臨床表現(xiàn)多樣,常累及十二指腸降部、回腸末端,內(nèi)鏡檢查對(duì)兒童腹型HSP診斷有價(jià)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.
【作者單位】： 鄭州兒童醫(yī)院消化內(nèi)科;
【分類號(hào)】：R725.5

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