诊断

一些 MIS-C 患儿对COVID-19 病毒当前感染检测呈阴性。这意味着他们目前尚无引起COVID-19的病毒。然而,证据表明,这些儿童中许多人最近感染过 COVID-19 病毒,如通过抗体试验阳性结果所示。

抗体试验阳性结果意味着儿童的免疫系统形成抗击COVID-19病毒的血液蛋白(抗体)。有时这项血液检查是这个孩子曾感染的唯一提示,这意味着这个孩子可能在无COVID-19体征和症状的情况下已经对抗感染。无论如何,还是有一些 MIS-C 患儿童目前感染了引起 COVID-19 的病毒。一般通过检出拭子的病毒确认这点,这种拭子取自鼻喉后部。

除了进行抗体检验和临床评估外,医生可能安排下列这些检查,以探求炎症和其他 MIS-C 体征:

  • 实验室检查,比如血液和尿液检查,包括探求血液中炎症标志物异常水平的检查
  • 影像学检查,如胸部 X 线检查、超声心动图、腹部超声法或 CT 扫描
  • 其他检查,取决于根据体征和症状

炎症会严重影响心脏、血管、肾脏、消化系统、大脑、皮肤或眼睛。

当医生怀疑 MIS-C 时,他们需要排除 COVID-19 活跃病例,以及其他炎性病症,比如川崎病、脓毒症或中毒性休克综合征,以便早期诊断和恰当治疗。

治疗

大多数患有 MIS-C 的儿童需要在医院接受治疗。有些需要在儿科重症监护室治疗。治疗通常包括支持性治疗和措施,以减少任何受影响的重要器官发炎,保护它们免受永久性损害。治疗取决于症状的类型和严重程度,以及哪些器官和身体的哪些部位受到炎症的影响。

支持性治疗可能包括:

  • 补充液体,如果液体水平过低(脱水)
  • 氧气,用于辅助呼吸
  • 血压药物,使休克相关的低血压恢复正常或辅助心脏功能
  • 呼吸机器(呼吸机)
  • 降低血栓风险的药物,如阿司匹林或肝素
  • 在极少数病例中,使用执行心脏和肺部工作的机器进行体外膜肺氧合 (ECMO)
  • 其他类型的治疗

减轻肿胀和炎症的治疗可包括:

  • 抗生素
  • 类固醇疗法
  • 静脉注射免疫球蛋白 (IVIG) ,一种由抗体组成的血液制品
  • 其他类型的治疗,比如靶向治疗,旨在减少被称为细胞因子的高水平蛋白质,这种蛋白质可导致炎症

没有证据表明 MIS-C 具有传染性。但是您的孩子有可能活动性感染了 COVID-19 病毒或其他类型的传染病。所以医院会在照顾孩子的同时采取感染控制措施。

临床试验

探索 Mayo Clinic 的研究 测试新的治疗、干预与检查方法,旨在预防、检测、治疗或控制这种疾病。

妥善处理与支持

如果您孩子的 MIS-C 病情严重,您可能感到极度焦虑和恐惧。由于 MIS-C 罕见,您可能不认识任何已经度过这段经历的任何人。为帮助应对此病可能造成的情感创伤,请寻求支持。这可以包括从与爱人和朋友谈论您的感受,到寻求心理健康专家帮助。要求您的卫生保健团队提供建议。为了您自己和孩子的利益,请勿尝试自行处理这种焦虑和苦恼。

通过获得足够的健康食物、睡眠和身体活动,尽量照顾好自己。尝试压力管理技巧(例如深呼吸、拉伸和冥想),帮助您度过这些艰难时刻。

准备您的预约

如果您的孩子出现 MIS-C 的任何紧急预警征兆或有其他严重疾病的体征和症状,请带孩子去最近的急诊室或拨打 911 或当地的急救电话。记得戴上口罩,保护自己和他人。

如果孩子的症状不是很严重,请联系孩子的儿科医生或其他医疗保健人员。医生可能会评估孩子的情况或立即将您转诊给传染病专科医生。

以下信息可以帮助您做好就诊准备。

您可以做什么

约诊时,请询问是否有任何需要提前准备的注意事项。请列出以下内容:

  • 您孩子的症状,包括症状开始出现的时间
  • 关键的个人信息,包括主要压力、近期的生活变化和家族病史
  • 您孩子服用的所有药物、维生素或其他补充剂及其剂量
  • 您的孩子最近参加的任何团体活动,包括日期
  • 要向医生咨询的问题

医生会采取什么措施

医生可能会问您和孩子(根据孩子的年龄而定)几个问题,例如:

  • 您的症状合适开始?
  • 症状有多严重?
  • 您的孩子是否进行过 COVID-19 检查?
  • 您的孩子是否接触过任何 COVID-19 病毒测试呈阳性的人员?
  • 您的孩子是否在上学?
  • 您的孩子最近是否参加过任何群体活动,例如运动会?
  • 您的孩子最近密切接触过哪些人员?

为就诊做好准备可以帮助确保让医生解答您的所有问题,并了解后续措施以及这些后续措施的重要性。

Nov. 12, 2021
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儿童多系统炎症综合征(MIS-C)和 COVID-19