胃镜检查对儿童过敏性紫癜的早期诊断价值研究

Application of gastroscopy to early diagnosis of Henoch-Schonlein purpura(HSP)in children

目的 探讨儿童过敏性紫癜(HSP)胃镜下黏膜病变特点及胃镜检查在其早期诊断中的价值。方法 回顾性分析2009年1月至2010年5月重庆医科大学附属儿童医院79例HSP患儿的胃镜结果。结果 HSP胃镜表现为胃肠道黏膜弥漫性充血水肿,广泛多发糜烂、溃疡、出血,尤其是黏膜类似于皮肤紫癜改变的出血点比较特异;胃镜检查发现病变沿上消化道越深入越明显,尤以十二指肠降部病变程度最严重;胃镜检查深入到达空肠输入端1例。结论 典型的胃镜下表现有助于HSP的早期诊断,尤其是无皮疹的HSP;胃镜检查可以明确胃肠道病变程度,指导临床治疗;在儿童HSP的早期诊断中,胃镜检查深入到空肠输入端十分必要。

Objective To study the gastroscopical features and to evaluate the application value of gastroscopy to early diagnosis of Henoch-Schonlein purpura （HSP） in children. Methods There were 79 children involved in a retrospeetiye analysis, who underwent gastroscopy and had HSP as final diagnosis between January 2009 and May 2010 in Children＇s Hospital of Chongqing Medical University. Results Gastroscopic findings included diffused congestive edema, widespread erosions and ulcerations in gastroduodenal mueosa while the mucosal ecchymosis highlighted the pathological changes, which were similar to the purpura in skin. More distal the gastroscopy reached along upper gast~＇ointestinal track, more severe the mueosal lesions manifested, as was especially significant in descending duodenum. T~ respond to clinical requirements, we pushed the gastroseope-tip to jejiJnum-input in one of all 79 cases. Conclusion Typical endoscopic findings in gastrodu0denal mucosa helps to make early diagnosis of HSP, especially HSP without purpura; gastroscopy can show the severity of gastrointestinal mucosal damages and be a guidance to clinical therapy. Finally, what we have to highlight is that it＇ s necessary to make the gastrosc6pe-tip （each jejunum-input for higher detection rate during the gastroscopic operation in early diagnosis of HSP in children.