儿童腹型过敏性紫癜胃肠道损害的彩超与胃镜表现

Doppler ultrasonography and endoscopy in gastrointestinal injury with allergic purpura abdominalis

目的探讨腹部彩超与胃镜检查对儿童腹型过敏性紫癜的胃肠道损害的诊断价值。方法结合临床特点回顾性分析126例腹型过敏性紫癜患儿腹部彩超及胃镜检查结果。结果 126例患儿均有腹痛,有或无伴阵发性加重,腹痛可出现皮肤紫癜前(n=22)、紫癜中(n=54)、紫癜后(n=50)。腹痛重而体征较轻微,腹部部位不固定。腹痛较轻者腹部超声多无阳性表现,腹痛持续或伴阵发性加重者腹部超声表现为病变部位肠管壁节段性水肿,血流增加,严重者可发现肠套叠、肠梗阻或肠坏死。胃镜下均有不同程度胃肠粘膜病理改变,包括胃肠粘膜充血、糜烂、点状出血及多发性溃疡。结论腹部彩超及胃镜检查对儿童腹型过敏性紫癜有早期诊断价值。

Objective To evaluate the usefulness of abdominal doppler uhrasonography and endoscopy in the diagnosis of gastrointestinal injury in children with purpura abdominalis. Method Abdominal doppler uhrasonography and endoscopy in 126 cases of allergic purpura were analyzed. Results All patients complained of abdominal pain with or without paroxysmal abdominal colics, before or meanwhile or after skin purpura. The symptom was serious, but abdomen physical sign was mild. The ache spot were not localized. Mitis patients had no positive finding in abdominal uhrasonography, but patients with obviously abdominal pain demonstrated single segmental oedema of the injured intestine,serious intussusception, intestinal obstruction and perforation. Endoscopy found mucous membrane had pathological changes in gastrointestinal tract with various degrees of hyperaemia, gedaucjed, dotor plateshaped blood, and multiple ulcers. Conclusion Early abdominal doppler uhrasonography and endoscopy examination had values in diagnosis with allergic purpura abdominalis.