以胃肠不适为首发症状的儿童荨麻疹56例临床分析

摘要

目的：总结以胃肠不适为首发症状的儿童荨麻疹的临床特征，提高诊疗水平。方法分析并总结56例以胃肠不适为首发症状的儿童荨麻疹，详细记录其一般资料、临床表现、辅助检查等。结果56例患者中男31例，女25例，胃肠不适中仅有腹痛者27例，仅有腹泻者12例，仅有呕吐者7例，腹痛伴呕吐4例，腹痛伴发热6例。血常规白细胞、中性粒细胞、C 反应蛋白均升高33例，仅有 C 反应蛋白升高18例，嗜酸粒细胞升高42例，腹部 B 超肝胆胰脾阑尾未见明显异常，腹部 X 线片未见异常，大便常规未见虫卵，肺炎支原体阳性1例。结论临床上以胃肠不适为首发症状的儿童荨麻疹并不少见，应仔细询问病史及进行详细的体格检查，了解患儿是否为过敏体质，有无荨麻疹病史，是否有过敏原接触史，全身有无风团样皮疹，皮肤划痕征是否阳性，在排除外科急腹症情况下积极给予抗过敏、抗感染、解痉及其他对症处理。%Objective To summarize the clinical feature of pediatric urticaria who started with gastro-intestinal discomfort,and improve diagnosis and treatment level.Methods Totally 56 cases child urticaria who started with gastrointestinal discomfort were analyzed,and the general information,clinical manifesta-tion,auxiliary examination were carefully recorded.Results There were 31 male patients and 25 female;the gastrointestinal discomfort included abdominal pain,diarrhea,vomiting,abdominal pain with vomiting and abdominal pain with fever,and the case number was 27,12,7,4 and 6,respectively.There were 33 cases of increase showed rising too in WBC,neutrophils and CRP,18 cases of increase in CRP,and 42 cases in eosin-ophilic granulocyte.There was nothing abnormal shown in abdominal ultrasonography and X-ray.Parasite eggs were not found in stool,but the Mp was positive in one case.Conclusion The pediatric urticaria that shows up as gastrointestinal discomfort firstly is not uncommon.Patients should be asked the medical histo-ry carefully and receive a detailed physical examination.In the case of exclusion of surgical acute abdomen, antiallergic,anti-infection,spasmolysis and other symptomatic treatment should be performed.