湖南地区上消化道出血患儿临床特征及胃镜下改变分析  

Analysis of the Clinical Characteristics and Gastroscopic Changes of Children with Upper Gastrointestinal Hemorrhage in Hunan Province

作　　者：陶佳 何志刚[1] TAO Jia;HE Zhigang(Chenzhou First people's Hospital,Hunan Chenzhou 423000,China)

机构地区：[1]湖南省郴州市第一人民医院儿童消化内科,湖南郴州423000

出　　处：《河北医学》2020年第5期850-854,共5页Hebei Medicine

基　　金：湖南省自然科学基金项目,(编号:17JJ5062)。

摘　　要：目的:分析上消化道出血患儿临床特征和胃镜下改变。方法:采用回顾性研究,收集本院95例上消化道出血患儿的临床资料,根据患儿年龄进行分组,分为<1岁组(13例)、1~2岁组(9例)、3~5岁组(22例)、6~13岁组(51例),对各组患儿症状表现、胃镜特点及发病诱因等情况进行分析,将所得数据纳入统计学分析。结果:各组患儿均出现黑便、呕血症状,且1~13岁的患儿均出现休克征、头晕乏力、腹痛症状。1~2岁组患儿黑便和呕血发生率均明显高于<1岁组、3~5岁组(P<0.05),而与6~13岁组的比较,并无明显差异(P>0.05);各组患儿其它临床表现的比较,并无明显差异(P>0.05)。经胃镜检查提示,贲门黏膜撕裂综合征、食管狭窄、糜烂性或出血性胃炎、十二指肠球炎、胃底食管静脉曲张、十二指肠球部溃疡、糜烂性或反流性食管炎是上消化道出血患儿的主要胃镜特点。相比6~13岁组,1~2岁组患儿糜烂性或反流性食管炎发生率显著升高(P<0.05),而其余各组胃镜特点的比较,并无明显差异(P>0.05)。1~2岁组患儿误服化学制剂的发生率显著高于其余各组(P<0.05),而各组其它发病诱因的比较,并无明显差异(P>0.05)。各组患儿治疗总有效率的比较,并无明显差异(P>0.05)。结论:湖南地区14岁以下上消化道出血患儿以黑便、呕血为首发症状较多见,胃镜特点以出血性或糜烂性胃炎为多见,但多数患儿无明显诱因,经内镜和药物治疗具有较高的治愈率。Objective:To analyze the clinical characteristics and gastroscopic changes of children with upper gastrointestinal hemorrhage.Methods:The clinical data of 95 children with upper gastrointestinal hemorrhage were collected by retrospective study.According to the age of the children,they were divided into three groups:the<1-year-old group(13 cases),the 1-2-year-old group(9 cases),the 3-5-year-old group(22 cases),the 6-13-year-old group(51 cases).The symptoms,gastroscopic characteristics and the predisposing factors of the children in each group were analyzed,and the data were included in the statistical analysis.Results:Black stool and hematemesis were found in all groups,and shock,dizziness,weakness and abdominal pain were found in all the children aged 1-13 years.The incidence of black stool and hematemesis in the 1-2-year-old group was significantly higher than that in the<1-year-old group and the 3-5-year-old group(P<0.05),but there was no significant difference compared with the 6-13-year-old group(P>0.05);there was no significant difference in other clinical manifestations in each group(P>0.05).Gastroscopy showed that the main gastroscopic characteristics of children with upper gastrointestinal hemorrhage were cardia mucosa tearing syndrome,esophageal stenosis,erosive or hemorrhagic gastritis,duodenal bulitis,gastroesophageal varices,duodenal bulbar ulcer,erosive or reflux esophagitis.The incidence of erosive or reflux esophagitis in the 1-2-year-old group was significantly higher than that in the 6-13-year-old group(P<0.05),but there was no significant difference in the characteristics of gastroscopy in the other groups(P>0.05).The incidence of children's misuse of chemicals in the 1-2-year-old group was significantly higher than that in the other groups(P<0.05);however,there was no significant difference in other predisposing factors(P>0.05).There was no significant difference in the total effective rate(P>0.05).Conclusion:Black stool and hematemesis are the first symptoms in children under 14 years old with

关 键 词：上消化道出血 儿童 临床特征 胃镜特点 发病诱因 

分 类 号：R725.7[医药卫生—儿科]