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目的通过总结川崎病的临床特点,提高诊治水平。方法对2004年3月至2009年12月住院的68例川崎病患儿的临床资料进行回顾性分析。结果 (1)本组病例中典型川崎病56例(82.4%);不典型川崎病12例(17.6%)。(2)四季均有发病,3、4、5月份为发病高峰。(3)典型川崎病临床均有发热、口腔黏膜弥漫充血、眼球结合膜充血、皮疹、肛周充血脱皮等,但一些症状和体征出现较晚。不典型川崎病不完全符合标准,需要借助超声心动图示冠状动脉病变及实验室检查如白细胞、血小板、血沉、C反应蛋白等来明确诊断。(4)丙种球蛋白加阿司匹林治疗有显著疗效(本组为98.5%)。结论对不明原因持续发热的小儿,要将川崎病纳入常规鉴别诊断中,并早期动态地进行超声心动图检查、实验室检查,才能减少漏诊和误诊;一旦临床考虑川崎病,立即给予静脉注射丙种球蛋白及阿司匹林治疗,应用愈早,效果愈好。
Objective To summarize the clinical features of Kawasaki disease and improve the diagnosis and treatment. Methods The clinical data of 68 children with Kawasaki disease hospitalized from March 2004 to December 2009 were analyzed retrospectively. Results (1) 56 cases (82.4%) of typical Kawasaki disease in this group and 12 cases (17.6%) of atypical Kawasaki disease. (2) The incidence of all four seasons, 3,4,5 month peak incidence. (3) The typical Kawasaki disease clinical fever, oral mucosa diffuse hyperemia, conjunctival hyperemia, rash, perianal congestion and peeling, etc., but some of the signs and symptoms appear later. Atypical Kawasaki disease does not fully meet the standards, need to use echocardiography coronary artery disease and laboratory tests such as white blood cells, platelets, erythrocyte sedimentation rate, C-reactive protein to confirm the diagnosis. (4) gamma globulin plus aspirin treatment has a significant effect (98.5% in this group). Conclusion In children with unexplained fever, it is necessary to include Kawasaki disease in the routine differential diagnosis and early dynamic echocardiography and laboratory tests to reduce missed diagnosis and misdiagnosis. Once Kawasaki disease is clinically considered, intravenous injection of Ac Globin and aspirin treatment, the application of the earlier, the better.