Evaluation Of Narrow Band Imaging For Children With Abdominal Henoch-schonlein Purpura

Objective: To observe the morphological characteristics of the intestinal mucosa in children with abdominal Henoch-Schonlein purpura by the narrow-band imaging technology.To evaluate clinical value of narrowband imaging in diagnosis and treatment of children with abdominal Henoch-Schonlein purpura and to summarize their clinical characteristic and diagnosis.Provide the resources for the standardized diagnosis and treatment of the disease.Methods: A total of 46 patients with abdominal Henoch-Schonlein purpura were enrolled into the observation group(NBI intervention)from November 2010 to February 2016.Diagnostic rates of white light and NBI endoscopy in abdominal Henoch-Schonlein purpura patients,Ig A positive rates of targeted biopsies and severe complications were retrospectively analyzed.A total of 25 patients with HSP with no NBI intervention admitted from 2007 to 2009 were randomly enrolled into control group.Data of control group were compared with those of observation group.Result:1.The abdominal HSP endoscopic characteristic changes include diffuseswelling,petechia,erosion,ulcer and nodular changes.According to the process of mucosal inflammation change and the operating experience of endoscopic surgeons,the changes of intestinal mucosa were divided into three periods(in some cases,two or three periods can occur at the same time),the congestion and swelling period,erosion and ulcer period,healing and repair period.2.In observation group,the diagnostic rate under NBI was significantly higher than that under white-light endoscopy [91.3%(42/46)VS 67.4%(31/46),P<0.05].Ig A positive rates of targeted biopsies under NBI was significantly higher than that under white-light endoscopy [95.7%(88/92)VS 69.6%(64/92),P<0.05].3.The intestinal mucosa is heavier in abdominal HSP,early endoscopic treatment with thrombin solution spraying,can strengthen local mucosa bleeding,healing and relieve clinical symptoms.Compared with control group,abdominal pain and blood stool relief time(10.96±5.32 d VS 19.68±4.29 d),fasting time(10.37±5.42 d VS 8.80±3.71 d),hospital stay(18.80±7.11 d VS 23.12±4.36 d),time of stool occult negative(11.41±6.30 d VS 19.12±4.09 d)in observation group were significantly shortened.4.A small number of patients with severe endoscopic manifestations, such as extensive erosion of the intestinal mucosa,the formation of multiple ulcers,may be sentenced to severe complications such as gastrointestinal bleeding,multiple intervention under NBI endoscopy,timely control the disease development.Conclusion:For the diagnosis and treatment of abdominal HSP in children,the clinical value of NBI endoscopy is higher.NBI endoscopy is helpful to improve the diagnostic rate of abdominal HSP,guided biopsy and can predict the occurrence of serious complications,but also to the serious condition of early endoscopic intervention,timely control of the disease,relieve clinical symptoms.