Kawasaki disease Treatment
Treatment for Kawasaki disease include medication and surgery, should treat according to its phase.
Kawasaki disease Treatment in Acute phase:
1. Gammaglobulin: Early intravenous gamma globulin plus oral aspirin treatment of Kawasaki disease can reduce the incidence of coronary artery aneurysms. It must be emphasized in the 10 days after onset of drug use. Daily use of intravenous immunoglobulin 400mg/kg, 2 ~ 4 hours input, for four days; At the same time, oral aspirin plus 50 ~ 100mg/kg d, at 3 to 4 times, for four days, after Run to 5mg/kg d, Dayton served.
2. Aspirin: Early oral aspirin can control the acute inflammatory process, to reduce coronary heart disease, but there is no control study showed that aspirin therapy can reduce the incidence of coronary artery aneurysms. Daily dose 30 ~ 100mg kg, at 3 to 4 times. Taking 14 days, the daily heat back to 3 ~ 5mg/kg, a Dayton clothing, a good harvest to the role of anti-platelet aggregation.
3. Corticosteroids: corticosteroids have always maintained that there is a strong anti-inflammatory effect, can alleviate the symptoms, but later found that corticosteroid easily lead to thrombosis, and impede the rehabilitation of coronary artery disease, and promote aneurysm formation, it would not be appropriate to just make use of strong corticosteroid treatment, such as pine. Unless myocarditis complicated with severe or persistent high fever with severe cases can be combined with strong pine and aspirin therapy for Kawasaki disease control the early inflammatory response in general not only by glucocorticoids.
Kawasaki disease Treatment in recovery phase:
1. Anticoagulant therapy: recovery, daily aspirin use 3 ~ 5mg/kg, 1 time use, to ESR, normal platelets, in the absence of coronary artery anomalies are generally in the incidence of 6 to 8 weeks after drug withdrawal. Since then 6 months, 1 year review echocardiography. On the legacy of coronary patients in chronic phase, will take a long-term use of anticoagulant drugs and close follow-up. A small coronary aneurysm of the single patient, long-term use of aspirin should be 3 ~ 5mg/kg d, until aneurysm regression. For those who can not tolerate aspirin, dipyridamole available daily 3 ~ 6mg/kg, at 2 or 3 times service. If patients with multiple coronary aneurysms should be long-term oral administration of aspirin and dipyridamole. Patients with larger tumor easy cause thrombosis and happen coronary artery stenosis or occlusion, can be treated by oral anticoagulant. These patients should be limited to activities, not to participate in sports. Every 3 to check the heart in June, if the performance of myocardial ischemia or a positive exercise test, coronary angiography should be made to understand the progress of stenosis. With more than the main coronary artery occlusion of patients receive long-term anticoagulant therapy should be repeated to check the heart, including cardiac scanning, exercise testing, coronary angiography, and to consider surgical treatment.
2. Thrombolytic therapy: for heart infarct and thrombosis patients or intravenous drug delivery catheter percutaneous coronary to coronary recanalization, myocardial reperfusion. 1 hour intravenous thrombolysis with urokinase type 20000u/kg, followed by an hour 3000 ~ 4000u/kg input. 1 hour of coronary artery administration of urokinase type 1000u/kg. Can also be used streptokinase, intravenous thrombolysis within 1 hour streptokinase input 10000u/kg, after half an hour and then 1. Fast dissolving drug for more than fibrin, the effect is better, no adverse reactions.
3. Coronary angioplasty: A balloon catheter for expansion of coronary artery stenosis cases.
4. Surgical treatment: indications for coronary artery bypass grafting are as follows: