Detailed introduction to modern treatment of Kawasaki disease

Many people may not have heard of Kawasaki disease, which causes some people who suffer from the disease to not receive timely treatment or misdiagnosis, which brings great trouble to recovery. Therefore, it is important to learn more about it. So how much do you know about the modern treatment of Kawasaki disease? Let me introduce it to you below.

1. Anticoagulant therapy: For cases in the recovery stage, 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 discontinued 6-8 weeks after onset. After that, echocardiograms are repeated 6 months and 1 year later. 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, dipyridamole can be used 3-6 mg/kg per day, divided into 2-3 times. Heart condition every year. If echocardiogram, clinical data or exercise test indicate myocardial ischemia, coronary angiography should be performed. Patients with multiple or larger coronary aneurysms should take angiography orally for a long time. Patients with multiple or larger coronary aneurysms should take aspirin and dipyridamole orally for a long time. Patients with giant tumors are prone to thrombosis, coronary artery stenosis or occlusion, and can use oral warfarin anticoagulants. These patients should limit their activities and not participate in sports. Check the heart 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.

2. Thrombolytic therapy: For patients with myocardial infarction and thrombosis, intravenous or percutaneous catheter puncture and intracoronary administration are used to promote coronary recanalization and myocardial reperfusion. Intravenous thrombolysis is performed within 1 hour with urokinase 20000u/kg, followed by 3000-4000u/kg per hour. Intracoronary administration is performed within 1 hour with urokinase 1000u/kg. Streptokinase can also be used, intravenous thrombolysis is performed within 1 hour with streptokinase 10000u/kg, and it can be used again half an hour later. The above drugs quickly dissolve fibrin, with good effects and no adverse reactions.

3. Coronary angioplasty: In recent years, the use of balloon catheters to dilate cases of coronary artery stenosis has been successful.

4. Surgical treatment: The indications for coronary artery bypass grafting are: ① high occlusion of the left main trunk; ② high occlusion of multiple branches; ③ high occlusion of the left anterior descending branch. For cases of severe mitral regurgitation, medical treatment is ineffective, and valvuloplasty or valve replacement can be performed. Japan reported 62 patients with Kawasaki disease who underwent coronary artery bypass surgery, of which 7 underwent mitral valve surgery at the same time. 70% of patients had angina pectoris, heart failure or other symptoms before surgery. The 4-year survival rate after surgery was 87%, and the 10-year survival rate was 45%. Most of them died of late myocardial infarction or sudden death.

Cardiogenic shock, heart failure and arrhythmias should be treated accordingly.

Traditional Chinese medicine believes that children have weak constitutions and are more susceptible to this disease when warm and harmful toxins invade the human body during seasonal changes. Therefore, Chinese medicine has achieved good results in treatment by promoting blood circulation, removing blood stasis, dispersing wind and clearing heat, etc., without any side effects and reducing complications.