世界最新医学信息文摘（电子版）
世界最新醫學信息文摘（電子版）
세계최신의학신식문적（전자판）
World Latest Medicine Information
2014年
15期
50-50,69
,共2页
川崎病%无菌性脑膜炎%治疗
川崎病%無菌性腦膜炎%治療
천기병%무균성뇌막염%치료
kawasaki disease%aseptic meningitis%treatment
目的：对我科2013年1月至12月收治的112例川崎病（Kd）中并发无菌性脑膜炎31例病例的临床特征、诊断、治疗进行回顾性分析。方法本组病例入院后按川崎病并无菌性脑膜炎治疗，本组病例均给予阿司匹林50mg/d/㎏，分2～3次口服，并给予甘露醇脱水降颅压等治疗。全部病例均给予静脉丙种球蛋白治疗。出院前本组病例均做了心脏二维超声心动图（2de）检查。结果全部病例出院时临床症状消失，病情好转出院。心脏2de 检查冠状动脉正常5例；异常26（83.87%）例冠状动脉均有不同程度病变。结论目前（Kd）己取代风湿热成为我国儿童后天性心脏病的最主要病因。近年来 Kd 并发无菌性脑膜炎的病例数有增多趋势，Kd 并发无菌性脑膜炎是川崎病的重症病例，本组病例中均并发多器官损伤。临床应引起高度重视。儿科医师要提高对 Kd 的认识，特别是 Kd 并发无菌性脑膜炎的病例，早期诊断、早期治疗是减少、减轻 Kd 并发冠状动脉病变的关键。
目的：對我科2013年1月至12月收治的112例川崎病（Kd）中併髮無菌性腦膜炎31例病例的臨床特徵、診斷、治療進行迴顧性分析。方法本組病例入院後按川崎病併無菌性腦膜炎治療，本組病例均給予阿司匹林50mg/d/㎏，分2～3次口服，併給予甘露醇脫水降顱壓等治療。全部病例均給予靜脈丙種毬蛋白治療。齣院前本組病例均做瞭心髒二維超聲心動圖（2de）檢查。結果全部病例齣院時臨床癥狀消失，病情好轉齣院。心髒2de 檢查冠狀動脈正常5例；異常26（83.87%）例冠狀動脈均有不同程度病變。結論目前（Kd）己取代風濕熱成為我國兒童後天性心髒病的最主要病因。近年來 Kd 併髮無菌性腦膜炎的病例數有增多趨勢，Kd 併髮無菌性腦膜炎是川崎病的重癥病例，本組病例中均併髮多器官損傷。臨床應引起高度重視。兒科醫師要提高對 Kd 的認識，特彆是 Kd 併髮無菌性腦膜炎的病例，早期診斷、早期治療是減少、減輕 Kd 併髮冠狀動脈病變的關鍵。
목적：대아과2013년1월지12월수치적112례천기병（Kd）중병발무균성뇌막염31례병례적림상특정、진단、치료진행회고성분석。방법본조병례입원후안천기병병무균성뇌막염치료，본조병례균급여아사필림50mg/d/㎏，분2～3차구복，병급여감로순탈수강로압등치료。전부병례균급여정맥병충구단백치료。출원전본조병례균주료심장이유초성심동도（2de）검사。결과전부병례출원시림상증상소실，병정호전출원。심장2de 검사관상동맥정상5례；이상26（83.87%）례관상동맥균유불동정도병변。결론목전（Kd）기취대풍습열성위아국인동후천성심장병적최주요병인。근년래 Kd 병발무균성뇌막염적병례수유증다추세，Kd 병발무균성뇌막염시천기병적중증병례，본조병례중균병발다기관손상。림상응인기고도중시。인과의사요제고대 Kd 적인식，특별시 Kd 병발무균성뇌막염적병례，조기진단、조기치료시감소、감경 Kd 병발관상동맥병변적관건。
objective the article is to review the 112 cases of Kawasaki disease (Kd) treaded in our department from January to december 2013 with the emphasis of their characteristics,diagnosis,treatment of patients with aseptic meningitis in 31 cases which were retrospectively analyzed. Methods according to Kawasaki disease and aseptic meningitis treatment, the patients were treated with aspirin 50mg/d/ kg,divided into 2 - 3 oral,and given mannitol intracranial pressure lowering treatment. all patients were given intravenous immunoglobulin therapy. Before discharging,cases in the group were given two dimensional echocardiogram Beckoning graph (2de) examination. results the clinical symptoms of all patients were disappeared,their condition improved and discharged. normal cardiac 2de examination of 5 cases of abnormal coronary artery:26 (83.87%) cases had different degrees of coronary artery lesions. conclusion the present (Kd) has replaced the wind damp heat and has become the most important cause of acquired heart disease for children. in recent years Kd with aseptic meningitis cases is increasing,Kd concurrent aseptic meningitis is Kawasaki disease in severe cases,in this group of cases were complicated with multiple organ injury. clinical attention should be paid. Pediatricians should raise awareness of Kd, especially Kd with aseptic meningitis cases. early diagnosis,early treatment is the key to reduce coronary artery disease complicated by Kd.
