1例川崎病合并消化道出血报道并文献复习  

Kawasaki Disease Complicated with Gastrointestinal Hemorrhage:Case Study and Literature Review

作　　者：王健[1] 宋琳[1] 季丽娜[1] 徐樨巍 Wang Jian;Song Lin;Ji Lina;Xu Xiwei(Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院,清华大学临床医学院,北京102218

出　　处：《儿科药学杂志》2025年第2期49-52,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨川崎病合并消化道出血的临床特点及治疗转归情况。方法:回顾性分析我院诊治的1例儿童川崎病合并消化道出血的临床资料,并复习相关文献。结果:患儿主因“发热4 d”入院,诊断为不完全性川崎病,给予丙种球蛋白和阿司匹林治疗,仍有反复发热,考虑丙种球蛋白无反应型,进行第二轮丙种球蛋白和甲泼尼龙治疗,患儿出现消化道出血,予对症支持治疗后纠正贫血,监测未再出现消化道出血后,加用小剂量阿司匹林和奥美拉唑好转出院。随访未再出现消化道出血及冠状动脉扩张。对于存在消化道症状的川崎病患儿,应注意观察患儿消化系统的症状变化,并监测大便潜血。结论:川崎病在应用阿司匹林治疗前后均存在消化道出血风险,消化道出血往往是溃疡出血,出血量大,需加强监测并及时治疗。Objective:To probe into the clinical characteristics and treatment process of Kawasaki disease complicated with gastrointestinal hemorrhage.Methods:Clinical data of a child with Kawasaki disease complicated with gastrointestinal hemorrhage were analyzed retrospectively and the related literature was reviewed.Results:The child was admitted due to“fever for 4 d”and was diagnosed with incomplete Kawasaki disease.After treatment with gamma globulin and aspirin,the child still had repeated fever,which was considered to be non-reactive.Round gamma globulin and methylprednisolone were added.The child developed gastrointestinal hemorrhage.After symptomatic and supportive treatment,the anemia was corrected.After monitoring for gastrointestinal hemorrhage,low-dose aspirin and omeprazole were added,the child was improved and discharged.No gastrointestinal hemorrhage or coronary artery dilation occurred during follow-up.For patients with Kawasaki disease with digestive symptoms,attention should be paid to observing the changes in the symptoms of digestive system and monitoring fecal occult blood.Conclusion:There is a risk of gastrointestinal hemorrhage in Kawasaki disease before and after aspirin treatment.Gastrointestinal hemorrhage is often caused by ulcer bleeding and the amount of bleeding is large.Enhancement of monitoring and timely treatment are needed.

关 键 词：川崎病 消化道出血 阿司匹林 

分 类 号：R725.4[医药卫生—儿科]