| 摘要: |
| 目的:探讨床旁超声指导下的精准药物治疗在儿科危重川崎病休克综合征(KDSS) 合并多浆膜腔积液患儿诊治中的应
用价值。方法:回顾分析1 例KDSS 合并多浆膜腔积液患儿的临床资料,并结合相关文献进行总结。结果:3 岁女童,以发热、颈
部肿胀、呼吸费力为主要表现,入院时病情危重,存在休克、多浆膜腔积液及典型川崎病表现,诊断为KDSS。治疗全程在床旁超
声指导下,根据“入院初-确诊后-治疗中-病情好转后”4 个阶段动态调整抗休克、抗炎、调节免疫及器官支持等药物方案,实现精
准液体管理和个体化治疗。最终患儿得以成功救治,预后良好。结论:KDSS 是川崎病严重的并发症,在床旁超声实时、动态监
测下,分阶段精准实施药物干预,是提高救治成功率的关键。 |
| 关键词: 床旁超声 川崎病休克综合征 多浆膜腔积液 精准药物治疗 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.11.008 |
|
| 基金项目:基金项目:河北省医学科学研究课题计划,编号20220742。 |
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| Staged Precision Pharmacotherapy Under Bedside Ultrasound Guidance for a Critically Ill Child withKawasaki Disease Shock Syndrome Complicated with Multiple Serosal Fluid Accumulation |
| Liu Shuai, Wang Zexi, Xu Meixian |
| (Hebei Provincial Clinical Research Center for Child Health and Disease, Hebei Children’s
Hospital, Shijiazhuang 050031, China) |
| Abstract: |
| Objective: To probe into the application value of bedside ultrasound-guided precision pharmacotherapy in the diagnosis and
treatment of a critically ill case of Kawasaki disease shock syndrome (KDSS) complicated with polyserositis. Methods: Clinical data of
a child with KDSS complicated with polyserositis were retrospectively analyzed, and the relevant literature was summarized. Results: A
3-year-old girl was admitted with fever, neck swelling, and respiratory distress. The child was critically ill on admission, presenting with
shock, polyserositis, and typical Kawasaki disease manifestations, leading to a diagnosis of KDSS. Throughout the treatment, guided by
bedside ultrasound, the pharmacotherapeutic regimen including anti-shock, anti-inflammatory, immunomodulatory, and organ support
therapies, was dynamically adjusted across four stages (initial admission, post-diagnosis, during treatment, and after improvement).
The treatment regimen enabled precise fluid management and individualized treatment. The child was successfully rescued with a good
prognosis. Conclusion: KDSS is a severe complication of Kawasaki disease. Real-time, dynamic monitoring with bedside ultrasound to
implement phased and precise pharmacotherapy is crucial for improving the success rate of rescuing such critical conditions. |
| Key words: bedside ultrasound Kawasaki disease shock syndrome polyserositis precision pharmacotherapy |
