临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
9期
881-884
,共4页
川崎病%冠状动脉血栓%溶栓治疗
川崎病%冠狀動脈血栓%溶栓治療
천기병%관상동맥혈전%용전치료
Kawasaki disease%coronary thrombus%thrombolysis therapy
目的：观察川崎病(KD)冠状动脉瘤并发血栓药物治疗的效果。方法回顾性分析8例KD冠状动脉瘤合并血栓患儿的临床资料。结果8例KD患儿年龄0.2~5.2岁；男6例，女2例。冠状动脉瘤瘤体内径8.3~13.8 mm，血栓发生时间在冠状动脉瘤形成后19 d至5月余。初发症状为突发胸痛1例，有心肌梗死伴心力衰竭症状；休克样症状1例；无症状6例。心脏超声检查发现瘤内血栓最大径2.8 mm×15.4 mm，呈长段条索状。冠状动脉血栓右侧4例，左侧2例，双侧2例。使用肝素、尿激酶溶栓，华法林、阿司匹林及潘生丁抗凝，抗血小板治疗。7例消溶成功，完全消溶所需要时间7d至4月余。1例4个月后血栓复发；1例发病12 h死亡。结论 KD冠状动脉瘤合并血栓好发于KD发病半年内，药物溶栓治疗需要时间较长，血栓脱落不多见。
目的：觀察川崎病(KD)冠狀動脈瘤併髮血栓藥物治療的效果。方法迴顧性分析8例KD冠狀動脈瘤閤併血栓患兒的臨床資料。結果8例KD患兒年齡0.2~5.2歲；男6例，女2例。冠狀動脈瘤瘤體內徑8.3~13.8 mm，血栓髮生時間在冠狀動脈瘤形成後19 d至5月餘。初髮癥狀為突髮胸痛1例，有心肌梗死伴心力衰竭癥狀；休剋樣癥狀1例；無癥狀6例。心髒超聲檢查髮現瘤內血栓最大徑2.8 mm×15.4 mm，呈長段條索狀。冠狀動脈血栓右側4例，左側2例，雙側2例。使用肝素、尿激酶溶栓，華法林、阿司匹林及潘生丁抗凝，抗血小闆治療。7例消溶成功，完全消溶所需要時間7d至4月餘。1例4箇月後血栓複髮；1例髮病12 h死亡。結論 KD冠狀動脈瘤閤併血栓好髮于KD髮病半年內，藥物溶栓治療需要時間較長，血栓脫落不多見。
목적：관찰천기병(KD)관상동맥류병발혈전약물치료적효과。방법회고성분석8례KD관상동맥류합병혈전환인적림상자료。결과8례KD환인년령0.2~5.2세；남6례，녀2례。관상동맥류류체내경8.3~13.8 mm，혈전발생시간재관상동맥류형성후19 d지5월여。초발증상위돌발흉통1례，유심기경사반심력쇠갈증상；휴극양증상1례；무증상6례。심장초성검사발현류내혈전최대경2.8 mm×15.4 mm，정장단조색상。관상동맥혈전우측4례，좌측2례，쌍측2례。사용간소、뇨격매용전，화법림、아사필림급반생정항응，항혈소판치료。7례소용성공，완전소용소수요시간7d지4월여。1례4개월후혈전복발；1례발병12 h사망。결론 KD관상동맥류합병혈전호발우KD발병반년내，약물용전치료수요시간교장，혈전탈락불다견。
Objective To observe the efficacy of drug treatment of coronary aneurysm complicated with embolism in Kawasaki disease (KD). Methods The clinical data of eight KD children with coronary aneurysm and embolism were retrospectively analyzed. Results Eight KD children (six males and two females) at age of 0.25-5.2 years (mean=2.89) ,were diagnosed with gigantic coronary artery aneurysms. The diameter of aneurysm was around 8.3-13.8mm. Thrombosis appeared from 19 days to five months after coronary aneurysms formation. The onset manifestations included sudden chest pain and myocardial infarction with symptoms of heart failure in one case, shock in one case and no symptom in six cases. The maximum diameter of the thrombus was 2.8 mm×15.4 mm in the shape of funicular. Four cases had thrombus in the right coronary artery, two cases in the left coronary artery, and two cases in both sides. The patients underwent anticoagulant therapy taking heparin, urokinase, warfarin, aspirin and dipyridamole. Anticoagulant therapy was successful in 7 cases and the thrombus was completely dissolved in 7 days to more than 4 months. One case had recurrent coronary thrombosis after 4 months. One case died in 12 hours after thrombolysis. Conclusions Coronary thrombosis usually appears in the half year after the onset of KD coronary aneurysm. Thrombolysis therapy takes long time in Kawasaki patients. Breaking off of thrombus are rarely seen.
