以阴囊急症为首发症状的过敏性紫癜的治疗  

Acute scrotum as the first symptom of Henoch-Schonlein purpura： report of 14 cases

作　　者：白明[1] 孙熠[2] 张敬悌[1] 葛文安[1] 王盛兴[1] 郭涛[1] 杨增雷[1] 张岗[1] 

机构地区：[1]西安市儿童医院泌尿外科,710003 [2]西安市儿童医院血液肿瘤科,710003

出　　处：《中华小儿外科杂志》2012年第2期109-112,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的 总结14例以阴囊急症为首发症状的过敏性紫癜的发病及转归特点,以期提高对该类疾病的综合认识.方法 回顾2001年7月至2010年3月本科收治的14例以阴囊急症为首发症状的过敏性紫癜的临床资料.14例入院时均没有皮疹,其中8例诊断为睾丸附睾感染；3例诊断为睾丸附件扭转；2例诊断为睾丸扭转；1例诊断为双侧睾丸挫伤、会阴腹股沟软组织挫伤.1例合并腹痛,1例合并左膝关节肿痛.结果 5例患儿在入院后2～8 h出现皮肤紫癜,8例在入院后12～36 h出现皮肤紫癜,外伤的1例患儿入院后逐渐出现右膝关节肿痛转内科治疗,转科后2d出现皮疹.内科综合治疗后阴囊症状逐渐消失.所有患儿出院后均在血液科门诊随访3个月至5年,所受累阴囊睾丸未见异常.结论 以阴囊急症为首发症状的过敏性紫癜临床上不多见,超声在小儿阴囊急症的诊断中具有较高的准确性.对临床表现为阴囊急症尤其合并腹痛、关节肿痛的儿童需考虑到存在过敏性紫癜的可能性,综合的判断分析能够尽可能减少不必要的探查手术.Objective To summarize the characteristics and clinical outcome of 14 cases of Henoch-Schonlein purpura （HSP） in children with acute scrotum as its first symptom.Methods We retrospectively reviewed the clinical data of 14 male children with HSP between July 2001 and March 2010.None of the children had skin eruption at the time of admission.Eight children were diagnosed as epididymo-orchitis.Three were diagnosed as torsion of the testicular appendage.Two children were diagnosed as testicular torsion.And one child was diagnosed as having bilateral testicular contusions.One case had associated abdominal pain,one case had left knee joint swelling and pain.Results Five children developed skin purpura 2-8 hours after admission.In eight cases,eruptions were found 12 36 hours after admission in 12 to 36 hours.In the patient who had right knee joint swelling and pain,skin eruption developed on the second day.The scrotal symptoms gradually disappeared in all after medical treatment.No complication was noted during follow up 3 months- 5years （mean 30 months） after discharge.Conclusions Henoch-Schonlein purpura （HSP） in children with acute scrotum as its first symptom is a relatively rare event,but should be borne in mind for doctors.Ultrasonography has high diagnostic accuracy in children with an acute scrotum,and this should be performed with careful physical examination to avoid unnecessary surgery.

关 键 词：阴囊 损伤 过敏性紫癜 超声检查 预后 

分 类 号：R725.5[医药卫生—儿科]