腹型过敏性紫癜治疗前后电子内镜下胃肠粘膜病变特点

Endoscopic observation on the characteristics of gastrointestinal mucosa in Henoch-Schnlein purpura before and after tredtment

【目的】利用电子内镜观察腹型过敏性紫癜治疗前后胃肠粘膜病变特点,指导临床治疗。【方法】确诊患者64例,于治疗前、治疗后2周、4周分别内镜检查,观察胃肠粘膜病变特点。【结果】治疗前胃肠粘膜均有广泛粘膜下出血斑点,重者糜烂、溃疡。粘膜病变检出率依次为十二指肠52(81.2%),胃48(75.0%),回肠末端34(53.1%),结肠32(50.0%)。治疗2周后复查,胃、十二指肠粘膜病变明显减轻,出血斑点消失,四周后观察有些溃疡并未完全愈合。结肠病变治疗2周粘膜病变明显减轻,4周后粘膜恢复正常。【结论】腹型过敏性紫癜治疗前均有不同程度胃肠粘膜病变。治疗首选糖皮质激素,但激素影响溃疡愈合,因此在治疗同时应当加用抑酸药及粘膜保护剂,以促进溃疡愈合。

[Objective] To study the characteristics and changes of mucous membrane on stomach, duodenum and colon in Henoch-Sehoenlein purpura before and after treatment by electron endoscope. [Methods] Endoscopy was given to 64 patients before treatment and 2 weeks and 4 weeks after treatment. [Results] Before treatment, there were extensive petechia under the mucous membrane of stomach, duodenum and colon. Besides, there was mucous membrane bleeding and edema or even erosion and ulcer. The incidence rate was 81.2% in duodenum, 75.0% in stomach, 53.1% in ileum and 50.0% in colon. 2 weeks after treatment, the peteehia dispeared, bleeding and edema lightened, 4 weeks after treatment some ulcer still exist. [ Conclusions] There are extensive pathological changes of mucous membrane before treatment, glucoeorticoids is often used in the treatment of Henoch-Schoenlein Purpura, but it affects the healing of mucous membrane. To promote healing of ulcer the antacid and mucous membrane proteetant should be added to the treatment.