儿童消化性溃疡病140例临床分析  

Clinical analysis of 140 cases of pediatric peptic ulcer

作　　者：陈凤[1] 刘文莉 耿岚岚 谢晓莉 郭艳芳[5] 朱朝敏[1] 

机构地区：[1]重庆医科大学附属儿童医院消化科,重庆400014 [2]贵阳市儿童医院消化科,贵州贵阳550003 [3]广州市妇女儿童医疗中心消化科,广东广州510000 [4]成都市妇女儿童中心医院消化科,四川成都610091 [5]新疆医科大学附属第一医院儿科,新疆乌鲁木齐830054

出　　处：《中国实用儿科杂志》2015年第2期124-127,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨儿童消化性溃疡病的临床表现、胃镜特点及预后情况。方法对2011年9月至2013年2月期间重庆医科大学附属儿童医院、贵阳市儿童医院、广州市妇女儿童医疗中心、成都市妇女儿童中心医院、新疆医科大学附属第一医院的140例儿童消化性溃疡病患儿进行前瞻性研究,观察其症状、体征、并发症、胃镜表现,并随访治疗后第10天、第8周和第12周临床症状缓解率及第8周溃疡愈合率和幽门螺杆菌(Hp)根除率。结果 140例患儿年龄3.0~17.7岁,男女之比为2.8∶1,出现腹痛118例、呕吐71例、黑便57例、恶心54例、腹部不适32例、呕血31例、腹胀24例、反酸22例、口臭22例、嗳气17例、面色苍白14例、血便6例、纳差4例、腹部压痛110例,68例出现并发症,十二指肠溃疡84例、胃溃疡49例、复合溃疡7例,Hp阳性患儿占43.9%,各临床表现于开始治疗后第10天、第8周和第12周缓解率均较高,腹痛在3个时间段的缓解率分别为97(69.3%)、125(89.3%)、126(90.0%),差异具有统计学意义(χ2=27.256,P=0.000),溃疡愈合率为66.9%,Hp根除率为76.4%。结论儿童消化性溃疡病的临床表现具有多形性,经正规治疗一般预后良好。Objective To investigate the clinical manifestation, gastroscopic features and prognosis of peptic ulcer disease in children. Methods From September 2011 to February 2013, the medical records of 140 cases of peptic ulcer disease in Children＇s Hospital of Chongqing Medical University, Guiyang Maternal and Child Hospital, Materhal and Child Health Care Hospital of Guangdong Province, Sichuan Maternal and Child Hospital and First Affiliated Hospital of Xinjiang Medical College, were analyzed prospectivly, whose symptoms, signs, complications and gastroscopic manifestation were also observed, the symptom remission rates followed up at tenth day, eighth week and twelfth week after treatment, and eighth-week ulcerated healing rates and Helicobacter pylori （Hp） eradicative rates at eighth week after treatment. Results The subjects＇ ages ranged between 3 and 17.7, and the sex ratio was about 2.8：1. Abdominal pain, vomiting, melena, nausea, abdominal discomtbrt, hematemesis, abdominal distension, sour regurgitation, ozostomia, eructation, pallor, bloody stools, poor appetite and abdominal tenderness were presenting symptoms in 118 cases, 71 cases, 57 cases, 54 cases, 32 cases, 31 cases, 24 cases, 22 cases, 22 cases, 17 cases, 14 cases, 6 cases, 4 cases and 110 cases respectively. Complications occurred in 68 cases; there were 84 cases of duodenal ulcer, 49 cases of gastric ulcer, and 7 cases of complex ulcer; the inspection of Hp was positive for 43.9% of children. All the clinical remission rates were higher, and abdominal pain remission rates at each period time had significant disparity;ulcerated healing rate was 66.9% and Hp eradicative rate was 76.4%. Conclusion The clinical manifestation of peptic ulcer in chilren is pleomorphic, and peptic ulcer could be successf^ully cured generally after proper therapy.

关 键 词：儿童 消化性溃疡 胃镜 

分 类 号：R72[医药卫生—儿科]