儿童慢性腹痛临床特征分析  

Analysis of clinical characteristics of chronic abdominal pain in children

作　　者：孙治环 宋国鑫[1] 高若辉 张青松[1] 张建磊[1] 

机构地区：[1]威海市立医院小儿外科,山东省威海264200

出　　处：《中国基层医药》2017年第4期555-558,I0004,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：分析儿童慢性腹痛（CAP）临床发病率、分布特征、临床特点及其致病的相关因素。方法利用医院 HIS 系统统计2011年1月至2015年12月门诊及住院2～14岁腹痛就诊儿童的临床资料，建立数据库，就年龄、性别、发作时间、持续时间、肠系膜淋巴结情况、是否手术情况进行统计学分析。结果2011年1月至2015年12月诊治2～14岁儿童腹痛13256例次，腹痛待诊7390例，其中 CAP 1005例（13．59％）。男女比例1．061。平均年龄6（2～14）岁，男孩发病平均年龄（6．02±2．87）岁，女孩（5．93±2．79）岁，两者差异无统计学意义（t ＝0．47，P ＝0．63）。发病年龄集中在3～7岁，发病率随年龄增长而减少。腹痛平均病程（16．70±11．69）个月，男孩（17．39±12．12）个月，女孩（15．96±11．19）个月，两者差异有统计学意义（t ＝1.93，P ＝0．05）。肠系膜淋巴结肿大731例（72．74％），年龄构成比随年龄增长而减少。儿童 CAP 发病趋势与儿童肠系膜淋巴结肿大年龄分布趋势一致。手术治疗21例，器质性病变占2．08％。结论3～7岁学龄前儿童是 CAP 发病高峰，但多是功能性病变，器质性病变很少，其中肠系膜淋巴结及阑尾病变是常见原因。儿童 CAP 的治疗目的是排除器质性病变，缓解腹痛，使患儿回到正常的日常生活方式，随着年龄增长腹痛可自行消失。Objective To analyze the clinical prevalence,distributed characteristic of different ages,clinical characteristics and pathogenic factors of chronic abdominal pain in children.Methods A database in which outpa-tient and inpatient of abdominal pain during 2 -14 years old were collected from January 2011 to December 2015 was established by utilizing HIS system.A statistical analysis was made in age,sex,onset time,time of duration,mesenteric lymph node status and surgical situation.Results A total of 13 256 times abdominalgia were enrolled from January 2011 to December 2015.7 390 patients were diagnosed as unexplained abdominal pain,including 1 005 patients （13.59%）were diagnosed as chronic abdominal pain.A male -to -female ratio was 1.06：1.The average age was 6 years（ranged 2 -14 years）.The average age of the boys was （6.02 ±2.87）years,which of the girls was （5.93 ± 2.79）years,there was no statistically significant difference between them（t =0.47,P =0.63）.The peak age of chro-nic abdominal pain in children was mainly from 3 to 7 years old.The incidence decreased with age increased.The average time of duration was （16.70 ±11.69）months,that of the boys was （17.39 ±12.12）months,and that of the girls was （15.96 ±11.19）months,there was statistically significant difference between them（t =1.93,P =0.05）. Mesenteric lymphadenectasis was detected in 731 patients（72.74%）.The age constituent ratio decreased with age increased.The peak age of the prevalence coincided with peak age of the mesenteric lymphadenectasis.21 patients underwent surgical procedures,organic lesions accounted for 2.08%.Conclusion The peak age of the prevalence of chronic abdominal pain in children is mainly from 3 to 7 years old.Potential organic causes are rarely linked to chronic abdominal pain in children.Most of them are functional abdominal pain.The appendix and mesenteric lymphadenecta-sis might play an important role in children with chronic abdominal pain.The therapeutic aim of CAP in children is to

关 键 词：腹痛 慢性 阑尾炎 肠系膜淋巴结 儿童 

分 类 号：R725.7[医药卫生—儿科]