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患者男,14岁。双下肢瘀点、瘀斑半月,加重伴腹痛10d。查体见四肢散在大小不等瘀点、瘀斑,以下肢为重,足背及手背可见淡紫色大片瘀斑,因合并剧烈的腹部疼痛及消化道出血,以“重症腹型过敏性紫癜”予以系统使用低剂量糖皮质激素配合静脉输注血浆及丙种球蛋白为主,同时辅以止痛、止血、镇静及营养支持等对症治疗。患者皮肤及消化道症状明显改善,腹痛仍反复发生。转入本院消化内科后肠镜检查未见明显异常,腹部立位片提示肠管积气,补充诊断不完全性肠梗阻,禁食水的同时继续使用激素控制原发病,加强抑酸、止血、解痉及营养支持,患者腹痛及消化道出血逐渐缓解,好转出院。
Patient male, 14 years old. Lower limb petechiae, petechiae half months, aggravated with abdominal pain 10d. Check the body see the size of scattered limbs ranging from petechia, ecchymosis, to the lower extremities as heavy, back and back of the hand visible lavender large ecchymosis, combined with severe abdominal pain and gastrointestinal bleeding, “severe abdominal hypersensitivity purpura ”System to use low-dose glucocorticoid with intravenous infusion of plasma and gamma globulin, supplemented by analgesic, hemostatic, sedation and nutritional support symptomatic treatment. Patients with skin and gastrointestinal symptoms improved significantly, abdominal pain is still repeated. Into the hospital after digestive endoscopy no significant abnormalities, the abdominal film prompted gut tube gas, supplementary diagnosis of incomplete intestinal obstruction, fasting water while continuing to use the hormone to control the primary disease, strengthen acid suppression, hemostasis , Antispasmodic and nutritional support, patients with abdominal pain and gastrointestinal bleeding gradually eased, improved discharge.