小儿蚕豆病73例临床分析-论文.pdf

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1、：·663··临床诊疗提示·dxJL蚕豆病73例临床分析芦鹤云【摘要】目的分析小儿蚕豆病的临床特点及治疗效果，加强对小儿蚕豆病的认识。方法选取1995-2011年我院收治的73例小儿蚕豆病，回顾性分析其发病诱因、I临床表现、实验室检查、治疗及预后。结果发病诱因：食用新鲜蚕豆64例，食用蚕豆粉丝3例，食用干蚕豆2例，母亲食用蚕豆后哺乳2例，食用蚕豆面条l例，食用蚕豆酱油1例。73例均先后出现皮肤、巩膜黄染，酱油样、葡萄酒样或浓茶样小便；68例合并口唇、睑结膜苍白；56例合并消化道症状：恶心、呕吐、腹痛、腹泻；55例合

2、并发热，最高体温39．2℃。59例精神萎靡，2例深昏迷。血红蛋白均降低，白细胞计数、血小板计数均升高，尿隐血试验、尿蛋白均阳性。明确诊断后立即禁食蚕豆及蚕豆制品，禁服氧化类药物。均输血1—2次，碱化尿液、使用激素、处理并发症、维持水电解质酸碱平衡。14例痊愈，57例好转出院，2例因就诊时间较晚，合并多脏器功能衰竭死亡。结论蚕豆病是本地一种常见的溶血性疾病，临床表现及实验室检查主要是贫血的表现，治疗以去除诱因、输血、对症治疗为主，及时治疗大多预后良好。【关键词】蚕豆病；症状和体征；治疗；预后【中图分类号】R725．5

3、66．1【文献标识码】Bdoi：10．3969／j．issn．1007—9572．2013．02．097ClinicalAnalysisof73CasesofChildrenwithFavismLUHe—yun．LinxiangPeoplesHospital，Lincang677000，China【Abstract】ObjectiveToanalyzethecharacteristicsandtreatmentforchildrenwithfavisminordertostrengthentheunderstand

4、ingofthisdisease．MethodsCauses，clinicalmanifestations，laboratorytest，treatmentandprognosiswereretro—spectivelyanalyzedin73childrenwithfavismadmittedtoourhospitalfrom1995to2011．ResultsThecausesoffavismwere：eatingfreshviciafaba(64cases)，eatingbroadbeanvermicelli

5、(3cases)，eatingdryviciafaba(2cases)，eatingmilkfrommotherwhohadeatenviciafaba(2cases)，eatingbroadbeannoodle(1case)andeatingbroadbeansoysauce(1case)．The73casesshowedxanthochromia，ictericsclera，soysauce，wineorstrongtea—likeurine．68caseshadcombinedpalelipsandpalpe

6、bralconjunctiva，56caseshadcombineddigestivetractsymptomslikenausea，vomit，abdominalpainanddiarrhea，55caseshadcombinedfeverwiththehighesttemperatureof39．2℃．59caseshaddispiritednessand2caseshaddeepcoma．Allthepatientshaddecreasedhemoglobin，increasednumerationofleu

7、kocyteandbloodplateletcountandpositiveurinaryoccultbloodtestandurineprotein．Afterclarifyingdiagnosis，allthepatientswerepreventedfromeatingviciafabaanditsrelatedprod—uctsaswellasoxidationdrugs．Thepatientswerethengiventransfusion，alkalizationofurine，hormonetreat

8、ment，andtreatmentofcomplicationsandmaintenanceofelectrolytebalance．Intheend，14patientswerereleasedfromhospitalafterrecovery，57patientswerereleasedfromhospitalafterimprovementand2pa