不完全川崎病并发咽后水肿的临床观察  

Clinical Observation of Incomplete Kawasaki Disease with Retropharyngeal Edema

作　　者：付红彬 王辉[1] 朱路路 FU Hongbin;WANG Hui;ZHU Lulu(Department of Pediatrics,Zaozhuang Maternal and Child Health Hospital,Zaozhuang,Shandong 277000,China)

机构地区：[1]枣庄市妇幼保健院儿科,山东枣庄277000

出　　处：《中国医药指南》2025年第7期45-48,共4页Guide of China Medicine

摘　　要：目的 探讨以咽后水肿为主要表现的不完全川崎病(IKD)的临床特征与诊疗。方法 选取枣庄市妇幼保健院儿科病房2023年7月至2024年8月收治的3例咽后水肿的IKD患儿的临床资料,并进行文献复习。结果 3例患儿均以“发热伴颈部疼痛及活动受限”起病,C反应蛋白及红细胞沉降率增高,颈部磁共振提示存在咽后水肿,而抗生素治疗无效。陆续出现川崎病(KD)的部分临床特征,给予大剂量丙种球蛋白及阿司匹林(氯吡格雷)后,体温恢复正常,颈部疼痛消失,无活动受限,炎症指标降至正常。住院期间及随访过程中未发现冠状动脉病变。共检索到中文文献3篇,报道3例,外文文献54篇,报道200余例。结论以咽后水肿为主要表现的KD罕见,临床应注意与咽后脓肿鉴别,减少不必要的抗生素使用,避免颈部穿刺,甚至切开引流等有创性操作。Objective To explore the clinical features,diagnosis and treatment of incomplete Kawasaki disease(KD)with retropharyngeal as the main manifestation.Methods A total of 3 patients with IKD with posterior pharyngeal edema from Zaozhuang Maternal and Child Health Hospital from July 2023 to August 2024 were selected.A literature review was also carried out.Results All of the three cases started with"fever with neck pain and restricted movement".C-reactive protein and erythrocyte sedimentation rate were significantly increased.MRI of the neck revealed retropharyngeal edema but antibiotic treatment was not effective.It developed part of the clinical features of KD.After the treatment with high-dose gamma globulin and aspirin(clopidogrel),body temperature returned to normal,pain and restricted movement of the neck disappeared.The inflammation index decreased to normal too.No coronary artery lesions were observed during hospitalization or follow-up.A total of three Chinese literatures were retrieved and three cases were reported.54 foreign literatures were retrieved and more than 200 cases were reported.Conclusions KD with retropharyngeal as the main manifestation is rare.It is necessary to distinguish with retropharyngeal abscess in clinical practice,to reduce the unnecessary use of antibiotics,to avoid invasive procedures such as neck puncture,even incision and drainage.

关 键 词：川崎病 咽后水肿 咽后脓肿 颈部疼痛 

分 类 号：R725.4[医药卫生—儿科]