不完全性川崎病误诊误治原因分析及处置对策

Causes of misdiagnosis and mistreatment of incomplete Kawasaki Disease and its countermeasures

目的探讨不完全性川崎病的误诊误治原因及处置对策。方法回顾性分析100例川崎病患儿的临床资料,根据临床表现及实验室检查,分析不完全性川崎病的误诊误治原因。结果 100例川崎病患儿中,不完全性川崎病45例(45. 00%),典型川崎病55例(55. 00%);不完全性川崎病的皮疹、眼球结膜充血、口唇充血皲裂、杨梅舌、手足硬肿的临床特征发生率与典型川崎病有显著差异(P <0. 05); 45例不完全性川崎病患儿中,误诊4例肺炎(8. 89%)、1例败血症(2. 22%);100例川崎病患儿均恢复正常,无复发。结论详细询问患儿病史,进行全面体格检查,给予必要实验室检查,可提高不完全性川崎病的诊断率。

Objective To explore the causes of misdiagnosis and mistreatment of incomplete Kawasaki disease and its countermeasures. Methods The clinical data of 100 patients with Kawasaki disease in our hospital were retrospectively analyzed. According to the clinical diagnosis, the causes of misdiagnosis and mistreatment of Kawasaki disease were analyzed. Results Among 100 cases with Kawasaki disease, there were 45 cases （45%） with incomplete Kawasaki disease, 55 cases （55%） with typical Kawasaki disease. There were significant differences between incomplete Kawasaki disease and typical Kawasaki disease in skin rash, conjunctival congestion, congestion and cracked lip, Myrica tongue, and swollen hand and foot （ P 〈0.05）. Out of 42 cases with incomplete Kawasaki disease, there were 4 cases with pneumonia （8.89%） and 1 case with sepsis （2.22%）. All of the 100 cases with Kawasaki disease returned to normal without recurrence. Conclusion Detailed medical history, physical examination and laboratory examination can improve the diagnostic rate of incomplete Kawasaki disease.