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医嘱川崎病定期复查 家长当耳旁风

2017-08-25 07:27:08   中国青年网

本报讯(记者黄莹 通讯员高琛琛)4岁小男孩在家玩耍时突然晕倒,从荆州转来武汉后才确诊是心肌梗塞。这么小的孩子竟然得了“老人病”,父母得知后都不敢相信。

小男孩锦锦家住荆州,今年4岁。23日上午,他在家玩耍时突然晕倒,紧急送到当地医院,检查发现心电图异常,医生建议转院。父母又带他赶到武汉儿童医院,最终被诊断为心肌梗塞。孩子的冠状动脉严重狭窄,大部分已被血栓堵死。医生立即对其进行介入溶栓,孩子才转危为安。父母得知后都不敢相信:小朋友怎么会得“老人病”?

医生详细询问病史后,父母才想起孩子以前曾患过川崎病。

一年前,锦锦曾高烧不退,身上出疹子,眼睛发红、嘴巴红肿脱皮,还手脚肿胀,被确诊为川崎病。在荆州治疗了一段时间后,孩子明显好转。出院时,医生叮嘱要定期复查。但出院后家长觉得孩子一切正常,也就没有按医生说的定期去医院复查。

“这就是孩子突然发作心梗的原因。”武汉儿童医院心血管内科主任张勇说,一般来讲,川崎病在发病10天内规范治疗效果较好,过了这个阶段,通常会并发心血管损害。但在孩子初次病发后,如果能坚持用药物治疗,定期回诊,一年内冠状动脉疾病的恢复率可高达90%。但是,如果从不复查,孩子的心血管就犹如被埋下了一颗“不定时炸弹”。

张勇介绍,川崎病是一种急性系统性血管炎,多见于5岁以下儿童,病因尚不清楚,目前认为与感染引起的免疫损伤有关。如果不及时治疗,会损害冠状动脉,严重影响心血管功能,甚至发生心梗、死亡。

据统计,武汉儿童医院一年会收治川崎病患儿约500例,其中1/4-1/5可能会发生冠状动脉病变。定期复查,是将险情控制在萌芽状态的最有力屏障。如果当时治疗后没有发生冠状动脉病变,需随访2-3年,如有病变,则需终生随诊。

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