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題名 | Gastrointestinal Manifestations and Complications of Henoch-Schonlein Purpura=類過敏性紫斑症之腸胃道表徵及其併發症 |
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作者 | 陳世彥; 江文山; | 書刊名 | 長庚醫學 |
卷期 | 27:3 2004.03[民93.03] |
頁次 | 頁175-181 |
分類號 | 417.5637 |
關鍵詞 | 類過敏性紫斑症; 胃腸道表徵; 併發症; 兒童; Anaphylactoid purpura; Henoch-Schonlein purpura; Children; Gastrointestinal manifestations; Complications; |
語文 | 英文(English) |
中文摘要 | 類過敏性紫斑症是一種較常見於兒童的全身性血管炎疾患。胃腸道的侵犯常可見,而且影響從輕徵的症狀到嚴重的併發症皆更可能。 方法:過去5年(從1995年7月至2000年6月),在我們醫院208個病童診斷是類過敏性紫斑症,一共有116個男性和92個女性,年紀最小的9個月大,最大的15歲,平均年齡為6.4歲,我們回顧他們的醫療記錄,並且將重點放在他們的胃腸道表徵以及併發症。對於他們的住院過程及治療也同時作分析。 結果:162個案例有胃腸道表徵,這些表現之中又以腹部絞痛最多,有159案例(佔98.1%)其次是嘔味有64案例(佔39.5%),嚴重併發症包括大量胃腸道出血有5例;腸套疊有1例;蛋白流失性腸症(protein losing enteropathy)有1例;有一例為胰臟炎。41個案例其骨腸道表現發生時間比皮膚病灶為早(佔25.3%),其中有5例接受腹部手術。包括四例因為懷疑急性盲腸炎或腹膜炎而開刀。另一個病人因為迴腸套迴腸的腸套疊(ileo-ileo instussusception)。 結論:胃腸道表現食在類過敏性紫斑症出現。腹部絞病是最常見的胃腸道表徵,有時會引起併發症,在我們的研究其併發症很少需要手術處理。 |
英文摘要 | Backgorund: Henoch-Sch?nolein purpura (HSP) is a systemic vasculitic disorder commonly affecting young children. Gastrointestinal (GI) involvement is frequently seen, and it varies from mild symptoms to severe complications. Methods: In the 5 years from July 1995 to June 2000, 208 children were diagnosed with HSP in our hospital. There were 116 males and 92 females with ages ranging from 9 months to 15 years (mean, 4.4 years; median, 5.5 years). Their medical records were reviewed. We focused on their gastrointestinal manifestations and complications. The hospital course and management of these patients were also analyzed. Results: GI manifestations were present in 162 cases (77.8%), and among them the most common presentation was colicky abdominal pain in 159 cases (98.1%), followed by vomiting in 64 cases (39.5%). Severe complications included massive GI bleeding in 5 patients, insussusception in 1, protein-losing enteropathy in 1, and a patient with pancereatitis. GI symptoms occurred before the manifestation of skin lesions in 41 patients (25.3%). Five of them underwent a laparotomy. Four cases were operated on due to suspicion of acute appendicitis or peritionitis. Another patient had an emergent operation due to ileo-ileo intussusception. Conclusions: GI manifestations of HSP are common. Colicky abdominal pain was the most common GI manifestation of Henoch-Sch?nolein purpura. Some patients may have GI complications, but those requiring surgical intervention in our study were rare. |
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