六个月龄以内婴儿完全与不完全川崎病99例回顾性分析

Current situation and progress of minimally invasive surgery for esophageal cancer

目的通过分析6个月龄以内婴儿完全与不完全川崎病(KD)的临床特点,提高对该年龄组KD尤其是不完全KD患儿的认识和诊断水平。方法收集2010年8月至2014年8月本院收治的6个月龄以内婴儿KD共99例,分为完全KD组及不完全KD组,对患儿临床资料进行回顾性分析。结果 6个月龄以内婴儿KD,以男孩多发,男女比例为1.75∶1,新生儿未见发病,2个月龄以内发病者少见(2.02%),2个月以上至6个月以内发病者多(97.98%)。完全KD 57例(57.58%),不完全KD 42例(42.42%)。婴儿KD主要临床表现出现频率由高至低依次为发热(100%)、眼球结合膜充血(86.87%)、皮疹(80.81%)、口唇充血皲裂(68.69%)、杨梅舌(59.60%)、手足蜕皮(59.60%)、手足硬肿(43.43%)、淋巴结肿大(34.34%),其他临床表现以卡疤改变较常见(47.47%)。实验室检查中低蛋白血症(62.77%)及无菌性脓尿(44.93%)发生率较高,冠状动脉损害发生率较高(34.34%)。两组KD病例在发病年龄及性别中差异无统计学意义,不完全KD组的临床表现出现频率较完全KD组均低,在实验室检查中,不完全KD组较完全KD组在血小板升高、血红蛋白下降、冠状动脉损害发生率方面,差异有统计学意义。结论 6个月龄以内婴儿KD临床表现常不典型,导致诊断治疗延迟,易累及冠状动脉,故应重视相关的临床表现及实验室检查,尽早行超声心动图检查。超声心动图发现冠状动脉异常对6个月龄以内婴儿KD尤其是不完全KD的确诊尤为重要。

Surgery is still the main therapy for esophageal cancer. And its surgery technology has made great progress since professor Wu Yingkai performed the first case in 1940. But traditional open surgery for esophageal cancer brings more surgical traumas and more postoperative complications than minimally invasive surgery. In addition to minimally invasiveness and postoperative good appearance,minimally invasive surgery also embraces many other advantages, such as slighter pain and less postoperative complications, etc, but many scholars hold different views on it. Despite the existing controversy, minimally invasive surgery for esophageal cancer has made great progresses over the past 20 years.