儿童过敏性紫癜合并外科并发症16例临床分析

Clinical analysis of 16 cases of henoch-schonlein purpura in children accompanied with surgical complications

目的探讨过敏性紫癜(HSP)合并肠套叠或肠穿孔的临床特点、诊疗经过及预后情况。方法回顾性分析河南中医药大学第一附属医院自2014年1月至2017年12月收治的10例HSP合并肠套叠,6例HSP合并肠穿孔病儿的临床表现、治疗、及预后。结果肠套叠腹痛时间1~5 d,肠穿孔腹痛时间7~11 d。10例肠套叠病儿均经彩超确诊,6例肠穿孔病儿均经CT确诊。肠套叠1例自行缓解,空气灌肠复位成功5例,4例行手术治疗。肠穿孔6例,其中1例行肠穿孔修补术,5例行肠切除吻合。结论 HSP引起肠套叠腹痛时间较短,肠穿孔腹痛时间相对较长。彩超诊断HSP合并肠套叠敏感性高,CT诊断HSP合并肠坏死敏感性高。早期诊断肠套叠、肠穿孔可减少不必要的手术、减轻手术创伤。

Objective To analyze the clinical characteristics,diagnosis and treatment and prognosis of the henoch-sch?nlein purpura(HSP) in children accompanied with surgical complications.Methods A retrospective study was conducted on the clinical manifestation,treatment and prognosis of 10 children with HSP accompanied with intussusception and 6 children with HSP accompanied by bowel perforation who had hospitalized in The First Affiliated Hospital of Henan University of CM from January 2014 to December 2017.Results The intervals between the onset of the abdominal pain and the intussusception was 1-5 days,and the intervals of intestinal perforation was 7-11 days.10 cases of intussusception were diagnosed by Ultrasound,and 6 cases of bowel perforation were diagnosed by CT scan.1 case of intussusception was self relieved,5 cases were treated by air enema and 4 cases were treated by surgical operation.1 case of bowel perforation was treated by intestinal repair and 5 cases were treated by intestinal anastomosis.Conclusion The intervals between the onset of the abdominal pain and the intussusception was shorter,and the intervals of intestinal perforation was rather long.Ultrasound is more sensitive for detecting intussusception and CT is more sensitive for bowel perforation.Early diagnosis of intussusception and perforation can reduce unnecessary surgery and surgical trauma.