Can Kawasaki disease be treated without surgery?

Can Kawasaki disease be treated without surgery? Many people have this question. In fact, the most important method to treat Kawasaki disease is medication. After suffering from this disease, it is very harmful to the body. Therefore, patients with this disease should receive timely treatment. So, what are the treatments for Kawasaki disease? Let me briefly introduce it to you below.

Aspirin: Early oral aspirin can control the acute inflammatory process and reduce coronary artery lesions, but no controlled studies have shown that aspirin treatment can reduce the incidence of coronary artery aneurysms. The dosage is 30-100 mg/kg per day, divided into 3-4 times. Japanese doctors tend to use small doses, based on the fact that they believe that acute patients have reduced aspirin absorption and increased clearance during the acute phase of Kawasaki disease, and that large doses are needed to achieve anti-inflammatory effects. After taking it for 14 days, reduce it to 3-5 mg/kg per day after the fever subsides, taken once, and the antiplatelet aggregation effect is fully achieved.

It has always been believed that adrenal cortex hormones have strong anti-inflammatory effects and can relieve symptoms, but it was later found that corticosteroids are prone to thrombosis, hinder the repair of coronary artery lesions, and promote aneurysm formation. Therefore, it is not appropriate to use corticosteroids such as prednisone alone for treatment. Unless there is a complication of severe myocarditis or persistent high fever in severe cases, prednisone and aspirin can be used in combination for treatment. In order to control the early inflammatory response of Kawasaki disease, corticosteroids are generally not used alone.

For anticoagulant therapy, patients in the recovery period should take aspirin 3-5 mg/kg per day, once a day, until the erythrocyte sedimentation rate and platelet count return to normal. If there is no coronary artery abnormality, the drug is generally stopped 6-8 weeks after the onset of the disease. Echocardiography should be repeated 6 months and 1 year thereafter. For patients with residual chronic coronary artery disease, long-term anticoagulant drugs and close follow-up are required. Patients with small single coronary artery aneurysms should take aspirin 3-5 mg/kg·d for a long time until the aneurysm disappears. For those who are intolerant to aspirin, 3-6 mg/kg per day can be used, divided into 2-3 times. Heart condition every year. If echocardiography, clinical data or exercise test indicate myocardial ischemia, coronary angiography should be performed. Patients with multiple or large coronary aneurysms should take oral angiography for a long time. Patients with multiple or large coronary aneurysms should take aspirin and dipyridamole for a long time. Patients with giant tumors are prone to thrombosis, coronary artery stenosis or occlusion, and oral warfarin anticoagulants can be used. These patients should limit their activities and not participate in sports. Check their heart condition every 3 to 6 months. If there are signs of myocardial ischemia or a positive exercise test, coronary angiography should be performed to understand the progression of stenosis. Patients with occlusion of one or more major coronary arteries should receive long-term anticoagulant therapy, repeated heart examinations, including myocardial scanning, exercise testing, coronary angiography, etc., and consider surgical treatment.

Thrombolytic therapy is used for patients with myocardial infarction and thrombosis by intravenous or percutaneous catheter puncture and intracoronary administration to promote coronary recanalization and myocardial reperfusion. Intravenous thrombolysis is performed by infusing 20,000 u/kg of urokinase within 1 hour, followed by 3,000 to 4,000 u/kg per hour. Intracoronary administration is performed by infusing 1,000 u/kg of urokinase within 1 hour. Streptokinase can also be used, and streptokinase is infused within 1 hour of intravenous thrombolysis, and can be used again half an hour later. The above drugs quickly dissolve fibrin, have good effects, and have no adverse reactions.