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论著:儿童急性腹型荨麻疹60例诊治分析
Study of 60 Cases of Acute Abdominal Urticaria in Children
唐慧 周莲宝 钱秋芳 宋玮 黄迎 郦斐 王朵勤 徐金华
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作者单位:复旦大学附属华山医院皮肤科
中文关键字:荨麻疹;儿童
英文关键字:Urticaria;Children
中文摘要:目的:提高对儿童急性腹型荨麻疹的诊断和治疗水平。方法:回顾分析60例儿童急性腹型荨麻疹的临床资料,并将其分为7岁以下组和7岁以上组,比较2组患儿临床特点和治疗的差异。分析患儿的年龄、性别、总住院天数、病程、病因、症状和体征、实验室检查、糖皮质激素应用的最高剂量(强的松当量)及应用的天数等。结果:16例(26.7%)患儿有明确发病诱因,主要为感染、过敏性食物和药物。以腹痛为首发症状的有17例(28.33%),腹痛和皮疹间隔的最长时间为3.5 d;7岁以上组患儿的腹痛程度显著重于7岁以下组(P=0.0378)。外周血白细胞计数异常升高者有42例(71.19%)。所有患者腹部B超检查(29例)和腹部X线片检查(12例)均无明显异常。按照强的松当量,糖皮质激素每公斤体质量单日最高剂量为(1.59±0.84) mg,该最高剂量应用的平均天数为(4.70±2.20) d,2组间差异无统计学意义(P>0.05)。结论:儿童急性腹型荨麻疹患儿的病情较重,感染、药物和食物是其常见的发病诱因,部分患儿首先出现腹痛的症状,易导致误诊或漏诊。糖皮质激素是治疗儿童急性腹型荨麻疹的首选用药,规范应用糖皮质激素有助于该病的治疗,并减少其不良反应的发生。
英文摘要:Objective: To improve the diagnosis and treatment of acute abdominal urticaria in children. Methods: Clinical data of 60 children with acute abdominal urticaria were retrospectively analyzed. According to age (below or above the age of 7), the patients were divided into two groups. Patients were evaluated for age, gender, total hospitalization time, course, etiology, symptoms and sings, laboratory examinations, the highest dosage of glucocorticoid and days of treatment with this highest dosage of glucocorticoid. Results: 16 patients have obvious causes (26.7%),including infections, foods and medications. A total of 17 patients (28.33%) presented abdominal pain as their first symptom and the longest interval between abdominal pain and rash was 3.5 days. The abdominal pain was significantly serious in patients above the age of 7 than those below the age of 7(P=0.0378). Forty two patients (71.19%) exhibited high level of white blood cell count in peripheral blood . There were no obvious abnormal signs in type B ultrasonic and plain abdominal radiograph of all patients (29 cases and 12 cases respectively). Calculated as prednisone dosage, the highest dosage of glucocorticoid was 1.59±0.84 mg/kg/d,and the days of treatment with this highest dosage were 4.70±2.20 days. There were no significant differences in the dosages and the treatment days of glucocorticoid between patients above the age of 7 and those below the age of 7(P>0.05). Conclusions: Children with acute abdominal urticaria may have infections, foods and medications before the onset. Abdominal pain is the first symptom in part of patients, which may lead to misdiagnosis. Glucocorticoid is the primary treatment strategy for acute abdominal urticaria. Standard treatment of glucocorticoid can help to improve the symptoms of acute abdominal urticaria in children, and reduce the incidence of adverse reaction.
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