不完全川崎病的诊断治疗分析

目的 探讨不完全川崎病的诊断和治疗原则.方法 对39例临床诊断为不完全川崎病患儿的诊断和治疗过程进行回顾性分析.结果 39例患儿发热时间均超过5 d( 100.0％),双侧球结膜充血30例(76.9％),口唇樱红、皲裂28例(71.8％),多形性红斑、皮疹21例(53.8％),手足硬肿20例(51.3％),颈部淋巴结肿大10例(25.6％).除发热外川崎病临床诊断特征中具有3项者22例(56.4％),具有2项者17例(43.6％).病程中检测C反应蛋白均增高,红细胞沉降率明显增快.确诊后静滴丙种球蛋白和口服阿司匹林均获得有效治疗.结论 对可疑病例高度重视并完善检查,可以早期诊断不完全川崎病,避免误诊及漏诊.

Analysis for diagnosis and treatment of incomplete kawasaki disease

Objective To explore the diagnosis and treatment of incomplete Kawasaki disease. Methods Aretrospective analysis was applied in 39 children patients clinically diagnosed as Kawasaki disease. Results Thirtynine cases were found to have a high temperature over 5 days（ 100% ） ,30 patients with bilateral conjunctival congestion （76.9%） ,28 cases with cherry pink and chapped lips （71.8%） ,21 patients with erythema multiforme and erythra（53.8% ）,20 cases with hand-foot scleredema（51.3% ）and 10 patients with cervical lymphatic enlargement （25.6%）. In addition to the high temperature ,22 cases were found to have three classic clinical diagnostic characterstics（56.4% ） ,and 17 patients with two classic characterstics（43.6% ）. During the course of disease,C-reactve protein was observed to increase, and erythrocyte sedimentation rate speed up significantly. Intravenous infusion of gamma globulin and oral administration of aspirin was confirmed to be effective for incomplete Kawasaki disease. Conclusion The careful observation and complete clinical examination was conducive to early diagnosis of incomplete Kawasaki disease instead of misjudge and missed diagnosis.