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目的总结分析成人腹型过敏性紫癜的临床与胃肠镜表现,以提高其诊断水平。方法回顾分析2012年7月—2015年5月收治的30例成人腹型过敏性紫癜的临床特点与胃肠镜下表现。结果 30例患者均有不同程度的腹痛,伴恶心、呕吐10例,黑便及暗红色血便12例。所有患者大便隐血均阳性。胃肠镜下表现为胃肠道黏膜弥漫充血水肿,多发糜烂及浅溃疡形成,病变以十二指肠病变最为多见且病变重,食管黏膜未见异常。常规抑酸及解痉药物治疗效果差,糖皮质激素应用有效。结论腹型过敏性紫癜患者十二指肠病变最为常见,胃肠镜检查对其早期诊断有较高诊断价值。
Objective To summarize the clinical and gastrointestinal manifestations of adult abdominal anaphylactoid purpura in order to improve their diagnostic level. Methods The clinical features and gastrointestinal endoscopic findings of 30 adult patients with idiopathic purpura admitted from July 2012 to May 2015 were retrospectively analyzed. Results All 30 patients had different degrees of abdominal pain, nausea and vomiting in 10 cases, melena and dark red bloody stool in 12 cases. All patients with occult blood were positive. Gastrointestinal microscopic manifestations of gastrointestinal mucosal diffuse congestion and edema, multiple erosions and shallow ulcers, lesions of the most common and severe lesions of the duodenum, esophageal mucosa was normal. Conventional acid suppression and antispasmodic drug treatment is poor, glucocorticoid effective. Conclusion Abdominal allergic purpura in patients with duodenal lesions is the most common, gastrointestinal endoscopy for early diagnosis of high diagnostic value.