川崎病并发胰腺炎诊治分析并文献复习  

Diagnosis and Treatment of Kawasaki Disease Complicated with Pancreatitis and Literature Review

作　　者：王珍全[1] 金佳蕙 仇慧仙[1] 张园海[1] 吴蓉洲[1] 陈其[1] 

机构地区：[1]温州医科大学附属第二医院育英儿童医院心血管科,浙江省温州市325000

出　　处：《中国全科医学》2015年第6期669-672,共4页Chinese General Practice

摘　　要：目的提高对川崎病并发胰腺炎临床诊断特点的认识。方法报道1例川崎病合并胰腺炎患儿的诊治过程,并综合回顾文献。结果男性,4岁,因＂颈部肿块、腹痛、呕吐＂入院。入院后出现发热、皮疹、结膜充血、指端脱皮,查体淋巴结肿大、杨梅舌,诊断为川崎病;有腹痛、呕吐表现,血淀粉酶、尿淀粉酶、血脂肪酶水平明显升高,且腹部B超提示胰腺肿大,诊断胰腺炎。回顾文献,包括本例共11例,其中男9例,女2例;年龄3-18岁。1例患儿胰腺炎的表现早于川崎病出现;4例晚于川崎病;其余6例患儿入院时同时具有川崎病、胰腺炎表现。结论川崎病并发胰腺炎临床上非常少见。在川崎病的整个诊疗过程中,尤其是发病2个月内的患儿,如有腹痛、呕吐、黄疸等表现,需警惕并发胰腺炎可能。Objective To raise awareness about the clinical characteristics and diagnosis of Kawasaki disease complicated with pancreatitis. Methods To report a patient with Kawasaki disease complicated with pancreatitis,and to review the literature. Results A four years old boy was hospitalized with neck mass, abdominal pain and vomit. Rash, fever,conjunctival hyperemia and finger desquamate occurred after admission. Lymph node enlargement and strawberry tongue were found by examination. So the case was diagnosed with Kawasaki disease. According to the clinical manifestation of abdominal pain and vomit,increased levels of serum amylase,urine amylase and serum lipase,and pancreatic enlargement suggested by abdominal ultrasound,the case was diagnosed with pancreatitis. By reviewing the literature,11 cases（ 9 cases of male,2 cases of female;age from 3 to 18 years old） with Kawasaki disease complicated with pancreatitis,including this case,were reported. For 1 case,symptoms of pancreatitis appeared earlier than those of Kawasaki disease; for 4 cases,symptoms of pancreatitis appeared later than those of Kawasaki disease; for the other 6 patients,symptoms of pancreatitis and Kawasaki disease appeared at the same time. Conclusion Kawasaki disease complicated with pancreatitis is rare. During diagnosis and treatment process of Kawasaki disease（ especially within 2 months of onset）, if abdominal pain, vomit and jaundice appear, pancreatitis should be considered.

关 键 词：黏膜皮肤淋巴结综合征 胰腺炎 病例报告 

分 类 号：R725.512.4[医药卫生—儿科] R725.761[医药卫生—临床医学]