儿童急性荨麻疹伴消化道症状96例临床特征分析

目的：了解伴有消化道症状的儿童急性荨麻疹的临床特征,以提高临床诊疗水平。方法：回顾性分析96例伴有消化道症状的儿童急性荨麻疹住院患儿的临床资料,根据是否伴有消化道感染分为A、B两组,A组不伴消化道感染,B组伴发消化道感染,比较两组患儿的临床特征和治疗的差异。结果：A组73例（76.0%）,B组23例（24.0%）。两组患儿消化道症状均以腹痛为主,其次还表现为腹泻、血便、恶心呕吐等症状,部分患儿可出现腹部压痛,此外,大便白细胞、大便隐血以及腹部彩超还可见异常。但A组腹泻、血便、腹部压痛、大便白细胞升高、大便隐血阳性及腹部彩超异常率均低于B组,两组比较差异有统计学意义（P〈0.05）。同时,A组腹痛较轻,腹痛随皮疹好转而缓解,抗过敏及糖皮质激素治疗有效;B组腹痛较剧烈,腹痛不随皮疹好转而缓解,解痉、抑酸或促胃动力等治疗有效。结论：伴有消化道症状的儿童急性荨麻疹是一类比较特殊的荨麻疹,风团水肿累及胃肠粘膜以及消化道感染均可导致消化道症状的发生。在诊疗过程中,应综合分析病史特点、临床特征,必要时可行内镜检查,作出正确的判断以及合理的处理。

Clinical Characteristics Analysis of 96 Cases of Pediatric Acute Urticaria with Gastrointestinal Symptom

Objective： To understand the clinical characteristics of pediatric acute urticaria with gastrointestinal symptom,and to improve the diagnosis and treatment level. Methods： Clinical data of 96 cases of pediatric acute urticaria with gastrointestinal symptom were analyzed retrospectively. According to whether accompanying gastrointestinal infection,the children were divided into group A and group B. Compare the clinical characteristics and treatment of the two groups. Results： Group A not accompanying gastrointestinal infection occupied 73 cases（76. 0%）,and group B accompanying gastrointestinal infection occupied 23 cases（24. 0%）. Abdominal pain was the most common symptom in two groups,meanwhile diarrhea,hematochezia,nausea,vomiting and abdominal tenderness also could be found in those children. In addition,the white blood cells（WBC）,occult blood（OB） of feces and abdomen ultrasound could be found abnormal. But the diarrhea,hematochezia,abdominal tenderness,the abnormality of stool WBC,stool OB and abdomen ultrasound of group A were significantly less common than group B（P〈0. 05）. Abdominal pain of group A was light,the remission was relative to rash,anti-allergy and glucocorticoid treatment was effective. Abdominal pain of group B was more severe,the remission was not relative to rash,spasmolytic,acid-inhibitory,or gastroprokinetic agents were effective. Conclusions： Pediatric acute urticaria with gastrointestinal symptom is a special kind of urticaria. Gastrointestinal symptoms can be caused by wheal involving intestinal mucosa or infection of intestinal tract. Therefore,in the clinic activities,we should comprehensive analysis history and clinical features,if necessary,we should also combine endoscopy or experimental therapy,to make correct diagnose and treatment.