内镜观察肠内营养缺失对儿童旷置结肠炎的影响  

The impacts of enteral nutrition deficiency in patients with diversion colitis

作　　者：刘海峰[1] 左楚清[1] 彭罕鸣[1] 李刚[1] 方琼[1] 李春娣[1] 

机构地区：[1]武汉市儿童医院,湖北武汉430016

出　　处：《临床儿科杂志》2009年第9期812-816,共5页Journal of Clinical Pediatrics

基　　金：武汉市卫生局科技资助项目(No.2007-47-12)

摘　　要：目的探讨肠内营养缺失对小儿旷置结肠炎发生发展的影响,以及小儿旷置结肠炎的内镜特点。方法收集1999年9月至2008年12月住院的126例旷置结肠炎患儿的临床及内镜检查资料,通过对患儿术前有无感染疾患、造口不同术式、术后有无症状、结肠旷置持续时间、造口关闭后炎症消失等因素进行分析,了解肠内营养缺失对小儿旷置结肠炎发生发展的影响。结果126例患儿按不同因素分类对照比较内镜观察结果,检出旷置结肠黏膜糜烂、溃疡、炎性息肉阳性率,有临床症状病例高于无临床症状者(P<0.05),旷置时间>3个月病例高于旷置时间<3个月者(P<0.05);阳性检出率高低与术前有无感染疾患、造口不同术式两因素无关(P>0.05);85例患儿造口关闭3个月后内镜追踪检查,旷置结肠炎自愈。结论肠内营养缺失是小儿旷置结肠炎发生发展的主要原因之一,内镜检查有利于小儿旷置结肠炎早期诊断与对症治疗。Objective To investigate the influence of enteral nutrition deficiency on the development of diversion colitis in children,and the endoscopic characteristics of diversion colitis in children. Methods Clinical data and results of endoscopic examination of one hundred and twenty six patients with diversion colitis were collected from September 1999 to December 2008. The associated factors including pre-operative infection,different surgically-created enterostomies,symptoms after surgery,duration of diversion colitis,disappearance of inflammation after the closure of stoma were analyzed. Results All of the patients were grouped using the above factors,the incidences of endoscopic changes including exclusion of colonic mucosa erosion,ulcers,inflammatory polyps were compared. The occurrence of above changes was much higher in patients with clinical symptoms（P 〈 0.05） ,and with diversion time more than 3 months（P 〈 0.05） . Positive infection rate and different surgical enterostomies were not significantly associated with the occurrence of above changes（P 〉 0.05） . Eighty-five patients received endoscopic examination 3 months after stoma closure operation,the results showed self-healing of diversion colitis. Conclusions Enteral nutrition deficiency was one of the main reasons for the development of diversion colitis in children. Endoscopy was a useful tool for early diagnosis and treatment of diversion colitis in children.

关 键 词：肠内营养 结肠炎 造口术 内镜检查 

分 类 号：R726.5[医药卫生—儿科]