87例儿童川崎病临床特点及护理  

Clinical features and nursing of 87 children with Kawasaki disease

作　　者：朱丽[1] 汪燕[1] 方瑞[1] 项云[1] 张坤龙[1] 戴瑞[1] ZHU Li;WANG Yan;FANG Rui;XIANG Yun;ZHANG Kunlong;DAI Rui(Department of Pediatrics,The Second Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院儿科,安徽合肥230000

出　　处：《皖南医学院学报》2024年第5期498-501,共4页Journal of Wannan Medical College

基　　金：安徽省卫生健康科研项目(AHWJ2022c006)。

摘　　要：目的:明确川崎病(KD)合并冠状动脉扩张的临床特征和实验室数据特点,提高临床医护人员对KD的认识和早期诊断,探讨儿童KD症状护理特殊用药护理及心理护理的临床效果,有效减少因KD引发的冠状动脉病变发生。方法:回顾性分析2019年1月1日~2022年10月1日安徽医科大学第二附属医院儿科收治的87例KD患儿的临床资料,其中合并冠状动脉损伤的患儿24例为冠状动脉损害组(CAL组),其余63例为无冠状动脉损害组(NCAL组)。分析两组患儿人口学特征、实验室检查和影像学结果等临床资料,采用多因素Logistic回归方法探索KD的独立危险因素;采用受试者工作特征(ROC)曲线评价各独立危险因素对KD早期诊断的预测价值。结果:CAL组KD患儿中,男童18例(75.0%),两组临床资料中四肢指(趾)端变化、颈部淋巴结肿大等差异均无统计学意义(P>0.05),男性、腹痛和呕吐联合预测冠状动脉损害的AUC为0.760(P<0.05),是发生KD冠状动脉损伤的独立危险因素,具有中等的诊断价值;CAL组降钙素原(PCT)水平高于NCAL组,差异有统计学意义(P<0.05);患儿超声心动图提示二尖瓣反流例数明显增多。优质护理提高服药依从性,降低用药不良反应率,减轻家属焦虑程度,改善KD患儿临床症状,提高临床护理满意度。结论:长期发热伴有胃肠道症状的男童、PCT显著增高者,需完善心脏彩超;男性、腹痛和呕吐可作为KD发生冠状动脉损害的危险因素。Objective:To clarify the clinical characteristics and laboratory data of Kawasaki disease(KD)complicated with coronary artery dilatation so as to improve the understanding and early diagnosis of Kawasaki disease in clinic care,explore the clinical effect of symptom nursing,special medication nursing and psychological nursing of children with Kawasaki disease,and effectively reduce the occurrence of coronary artery lesions from this entity.Methods:The clinical data were reviewed in 87 children of KD admitted to and treated in the Department of Pediatrics of the Second Affiliated Hospital of Anhui Medical University between January 1,2019 and October 1,2022.Of the 87 cases,24 were complicated with coronary artery injury.The demographic characteristics,laboratory and imaging findings as well as other clinical data were analyzed in all patients.Multivariate logistic regression model and receiver operating characteristic(ROC)curve were used to respectively analyze the potential risk factors and predictive value for the risk factors of KD.Results:Of the 24 KD children,18(75%)were complicated with coronary artery injury(CAL).There was no statistical difference between the two groups in the clinical data,including the changes at the tips of the fingers(toes),enlarged cervical lymph nodes and other data(P>0.05).The AUC by male,abdominal pain and vomiting for predicting CAL was 0.760(ranging from 0.7 to 0.9)(P<0.05).These three indexes were independent risk factors for incidence of CAL in KD,and were in moderate diagnostic value.In terms of laboratory test data,the value of procalcitonin(PCT)was significantly different(P<0.05).Echocardiography indicated that the number of cases of mitral regurgitation increased significantly.High quality nursing is helpful to improve the medication compliance,improve the clinical symptoms of patients with KD,reduce the incidence of adverse drug reactions,reduce the anxiety of family members,and improve the clinical nursing satisfaction.Conclusion:Boys with long-term fever accompanied by ga

关 键 词：川崎病 儿童 冠状动脉并发症 

分 类 号：R725.4[医药卫生—儿科] R473.72[医药卫生—临床医学]