| 摘要: |
| 目的:探讨川崎病合并消化道出血的临床特点及治疗转归情况。 方法:回顾性分析我院诊治的 1 例儿童川崎病合并消
道出血的临床资料,并复习相关文献。 结果:患儿主因“发热 4 d”入院,诊断为不完全性川崎病,给予丙种球蛋白和阿司匹林
治疗,仍有反复发热,考虑丙种球蛋白无反应型,进行第二轮丙种球蛋白和甲泼尼龙治疗,患儿出现消化道出血,予对症支持治
疗后纠正贫血,监测未再出现消化道出血后,加用小剂量阿司匹林和奥美拉唑好转出院。 随访未再出现消化道出血及冠状动脉
扩张。 对于存在消化道症状的川崎病患儿,应注意观察患儿消化系统的症状变化,并监测大便潜血。 结论:川崎病在应用阿司
匹林治疗前后均存在消化道出血风险,消化道出血往往是溃疡出血,出血量大,需加强监测并及时治疗。 |
| 关键词: 川崎病 消化道出血 阿司匹林 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.02.011 |
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| 基金项目: |
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| Kawasaki Disease Complicated with Gastrointestinal Hemorrhage: Case Study and Literature Review |
| Wang Jian, Song Lin, Ji Lina, Xu Xiwei |
| (Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua
University, Beijing 102218, China) |
| Abstract: |
| Objective: To probe into the clinical characteristics and treatment process of Kawasaki disease complicated with
gastrointestinal hemorrhage. Methods: Clinical data of a child with Kawasaki disease complicated with gastrointestinal hemorrhage were
analyzed retrospectively and the related literature was reviewed. Results: The child was admitted due to “ fever for 4 d” and was
diagnosed with incomplete Kawasaki disease. After treatment with gamma globulin and aspirin, the child still had repeated fever, which
was considered to be non-reactive. Round gamma globulin and methylprednisolone were added. The child developed gastrointestinal
hemorrhage. After symptomatic and supportive treatment, the anemia was corrected. After monitoring for gastrointestinal hemorrhage,
low-dose aspirin and omeprazole were added, the child was improved and discharged. No gastrointestinal hemorrhage or coronary artery
dilation occurred during follow-up. For patients with Kawasaki disease with digestive symptoms, attention should be paid to observing the
changes in the symptoms of digestive system and monitoring fecal occult blood. Conclusion: There is a risk of gastrointestinal
hemorrhage in Kawasaki disease before and after aspirin treatment. Gastrointestinal hemorrhage is often caused by ulcer bleeding and the
amount of bleeding is large. Enhancement of monitoring and timely treatment are needed. |
| Key words: Kawasaki disease gastrointestinal hemorrhage aspirin |
