小儿消化性溃疡320例临床特点及内镜特征分析  

Clinical characteristics and endoscopic features of peptic ulcer in 320 children

作　　者：朱忠生[1] 周少明[1] 王朝霞 ZHU Zhongsheng;ZHOU Shaoming;WANG Zhaoxia(Shenzhen Children＇s Hospital,Shenzhen 518026,China)

机构地区：[1]深圳市儿童医院消化内科,广东深圳518026

出　　处：《中国中西医结合儿科学》2018年第3期188-192,277,共6页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探讨320例小儿消化性溃疡的临床发病特点及内镜下的特征。方法 2014年1月至2017年1月因消化道症状在深圳市儿童医院消化内科行电子胃镜检查4 541例患儿,其中确诊消化性溃疡患儿320例,其中男254例,女66例;年龄1～14岁,其中≤3岁29例,>3～6岁75例,>6～12岁162例,>12～14岁54例;十二指肠溃疡218例,胃溃疡78例,其他溃疡24例;幽门螺杆菌阳性207例,阴性113例;溃疡面积<1cm 143例,1～2cm 145例,>2cm 32例;溃疡并发出血107例,并发幽门梗阻33例,并发穿孔1例。分析不同年龄患儿溃疡发生情况、溃疡发病的性别差异、溃疡发病部位、溃疡面积和患儿幽门螺杆菌感染情况。结果 (1)消化性溃疡以学龄期儿童(>6～12岁)发病率最高80.2%(130/162),其中十二指肠溃疡以学龄期儿童居多,胃溃疡以学龄前儿童居多。消化性溃疡不同类型在患儿各年龄段分布差异有统计学意义(P<0.05)。(2)消化性溃疡患儿男女之比为3.85∶1,其中十二指肠溃疡男女之比为3.19∶1,胃溃疡男女之比为5∶1;消化性溃疡患儿男性发病率显著高于女性,差异有统计学意义(P<0.05)。(3)320例消化性溃疡中幽门螺杆菌检出率较高64.7%(207/320);不同类型消化性溃疡患儿幽门螺杆菌检出率不同,其中以十二指肠溃疡患儿幽门螺杆菌检出率最高74.3%(162/218)。不同类型消化性溃疡患儿幽门螺杆菌检出率比较差异有统计学意义(P<0.05)。(4)不同年龄消化性溃疡患儿的幽门螺杆菌感染率比较差异有统计学意义(P<0.05)。(5)小儿消化性溃疡的溃疡面大小多在2cm以下,幽门螺杆菌阳性患儿比阴性患儿的溃疡面积明显增大,差异有统计学意义(P<0.05)。(6)消化性溃疡患儿并发症的发病率明显升高,其中出血及幽门梗阻并发症的发病率与幽门螺杆菌阴性患儿比较差异有统计学意义(P<0.05)。(7)十二指肠溃疡好发于前壁,其次为大弯侧;胃溃疡以胃窦居多,其次为胃角Objective To study the clinical characteristics and endoscopic features of peptic ulcer in 320 children.Methods A total of 4 541 children with digestive tract symptoms underwent electrogastroscopy in Shenzhen Children＇s Hospital from January 2014 to January 2017;320 of them were diagnosed with peptic ulcer,254 boys and 66 girls.Their age ranged from one to 14 years old,among whom 29 were under 3,75 between 3 and 6,162 between 6 and 12,and 54 aged 12 to 14 years.There were 218 cases of duodenal ulcer,78 cases of gastric ulcer,and 24 cases of other ulcer.Totally 207 cases were H.pylori-positive and 113 were negative.The ulcer area was less than 1 cm in 143 cases,1 to 2 cm in 145 cases,and2 cm in 32 cases.The ulcer was complicated with hemorrhage in 107 cases,with pyloric obstruction in 33 cases,and with perforation in one case.The following items were analyzed in the children at different ages：the incidence of ulcer,the gender difference,the site of disease,the area and the situation of H.pylori infection.Results（1）The incidence rate in the children of school age（6 to 12 years）was the highest（80.2%,130/162）;duodenal ulcer occurred mainly in school-age children;gastric ulcer occurred mainly in preschool children.There was statistical difference in the incidence of peptic ulcer among children of different ages（P〈0.05）.（2）The ratio of boys to girls in children with peptic ulcer was 3.85∶1,which was 3.19∶1 in duodenal ulcer and 5∶1 in gastric ulcer.The incidence rate in boys was significantly higher than that in girls in the children with peptic ulcer（P〈0.05）.（3）The detection rate of H.pylori in children with peptic ulcer was the highest（64.7%,207/320）,which was different in different types of peptic ulcer.The detection rate of H.pylori was the highest in children with duodenal ulcer（74.3%,162/218）;there was statistical difference in the rate in different types of peptic ulcer（P〈0.05）.（4）There was statistical difference in the rate of H.pylori infection in the

关 键 词：消化性溃疡 胃镜检查 幽门螺杆菌 儿童 

分 类 号：R725.7[医药卫生—儿科]