儿童周期性呕吐综合征的诊断与治疗(附41例报告)  

Diagnosis and Treatment of Cyclic Vomiting Syndrome in Children: Experience in 41 Cases

作　　者：吴淑娥[1] 

机构地区：[1]泉州市儿童医院神经康复科,福建泉州362000

出　　处：《临床军医杂志》2008年第5期757-759,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨儿童周期性呕吐综合征的临床特征、诊断、预防性治疗及疗效。方法对1995年3月-2006年3月我院确诊的周期性呕吐综合征30例的临床特征、治疗与预后的临床资料进行回顾性分析，分析普萘洛尔和阿米替林对预防性治疗周期性呕吐综合征的临床疗效。结果本组患儿发病年龄新生儿-14岁，男20例，女21例，初次症状发作的平均年龄为（4．9±3．3）岁（新生儿-14岁）；70％在清晨或午夜发病，临床表现为反复发作性呕吐；采用普萘洛尔或阿米替林的有效率分别达91％和55％。结论对典型的反复呕吐发作的周期性呕吐综合征患儿无需有创检查就可确诊，普萘洛尔对CVS的治疗效果优于阿米替林。Objective To evaluate the clinical presentation, diagnosis, response to prophylactic therapy and outcome of children＇ s cyclic vomiting syndrome （ CVS）. Methods During a period of March 1995 to March 2006, 41 consecutive children with a final diagnosis of CVS were evaluated, treated and followed up in our hospital. The patients were randomized into groups to receive either amitriptyline or propranolol as prophylactic treatment. Results There were 20 boys and 21 girls with mean onset age of 4.9 ± 3.3 years （ ranging from neonate to 14 years）. The attack time was from midnight to early morning in about 70% of the cases. The clinical manifestation was recurrent vomiting. After treatment, amitriptyline was effective on 10 out of 18 （55%） patients. Propranolol appeared to have a superior reaction and was effective on 21 out of 23 （91%） patients. Conclusion In the patients with typical clinical presentation of CVS, who are examined by experienced physicians, invasive workup is not necessary. Propranolol appears more effective than amitriptyline for prophylactic use in children with CVS.

关 键 词：周期性呕吐综合征 儿童 普萘洛尔 阿米替林 

分 类 号：R573[医药卫生—消化系统] R574[医药卫生—内科学]