CAJ | 학술논문

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.
목적 총결14례이음낭급증위수발증상적과민성자전적발병급전귀특점,이기제고대해류질병적종합인식.방법 회고2001년7월지2010년3월본과수치적14례이음낭급증위수발증상적과민성자전적림상자료.14례입원시균몰유피진,기중8례진단위고환부고감염；3례진단위고환부건뉴전；2례진단위고환뉴전；1례진단위쌍측고환좌상、회음복고구연조직좌상.1례합병복통,1례합병좌슬관절종통.결과 5례환인재입원후2～8 h출현피부자전,8례재입원후12～36 h출현피부자전,외상적1례환인입원후축점출현우슬관절종통전내과치료,전과후2d출현피진.내과종합치료후음낭증상축점소실.소유환인출원후균재혈액과문진수방3개월지5년,소수루음낭고환미견이상.결론 이음낭급증위수발증상적과민성자전림상상불다견,초성재소인음낭급증적진단중구유교고적준학성.대림상표현위음낭급증우기합병복통、관절종통적인동수고필도존재과민성자전적가능성,종합적판단분석능구진가능감소불필요적탐사수술.
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.