473例儿童无痛结肠镜结果分析  

Retrospective analysis of the characteristics of painless colonoscopy in 473 children

作　　者：张双红[1] 李丽龙 廖玉萍 万盛华[1] 许增华[1] 万宏[1] 黎友菊 LI Lilong;LIAO Yuping;WAN Shenghua;XU Zenghua;WAN Hong;LI Youju(Department of Digestive Medicine,Jiangxi Provincial Children's Hospital,The Affiliated Children's Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Colonoscopy Room,Jiangxi Provincial Children's Hospital,The Affiliated Children's Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)

机构地区：[1]江西省儿童医院南昌大学附属儿童医院消化内科,江西南昌330006 [2]江西省儿童医院南昌大学附属儿童医院肠镜室,江西南昌330006

出　　处：《临床儿科杂志》2020年第5期386-389,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童无痛结肠镜检查的安全性及临床应用价值,并评估结肠镜下息肉切除的可行性。方法回顾分析2017年7月至2019年7月473例实施无痛结肠镜检查患儿的临床资料,按患儿年龄分为婴幼儿期(<3岁)、学龄前期(3~6岁),学龄期(7~11岁)及青春期(12~16岁),并进行比较。结果共473例患儿,实施487次无痛结肠镜检查,其中婴幼儿59例,学龄前247例,学龄期121例及青春期46例。313例患儿检出肠道病变,主要为肠息肉259例、慢性结肠炎32例、克罗恩病7例及溃疡性结肠炎3例。不同年龄段儿童的肠息肉、慢性结肠炎、炎症性肠病及其他消化道疾病的分布差异有统计学意义(P<0.001);其中肠息肉在婴幼儿期和学龄前期所占比例较高,慢性结肠炎和炎症性肠病在学龄期和青春期所占比例较高。盲肠插镜率85.6%(417/487);检查操作中未出现呼吸抑制和心跳骤停等严重并发症,检查结束后2例患儿出现麻醉后寒颤。259例肠息肉患儿采用结肠镜下高频电圈套凝切除,3例出现术中出血、2例出现术后出血、2例出现术后肠穿孔。结论儿童无痛结肠镜检查安全、有效,有助于下消化道疾病诊断,不同年龄段儿童下消化道疾病分布不同;结肠镜下切除儿童息肉可行。Objective To evaluate the safety and clinical value of painless colonoscopy in children and the feasibility of colonoscopic polypectomy.Methods We retrospectively analyzed the results of 473 cases of painless colonoscopy in Jiangxi provincial Children's Hospital,from July 2017 to July 2019.The patients were divided into four groups as infancy(<3 years),preschool-age(3-6 years),school-age(6-11 years)and adolescence(12-16 years).The safety of painless colonoscopy,the caecal intubation rate,the detection of intestinal lesions and the feasibility of colonoscopic polypectomy were analyzed.Results The 473 patients had accepted painless colonoscopy for 487 times,including 59 infancy cases,247 preschool-age cases,121 schoolage cases and 46 adolescence cases.The colonoscopy records showed that 313 cases were detected to have intestinal lesions including intestinal polyp(n=259),chronic colitis(n=32),Crohn’s disease(n=7),and ulcerative colitis(n=3).There were significant differences in the overall ratios of polyps,chronic colitis,Crohn's disease and ulcerative colitis in children among different age groups(χ^2=44.094,P<0.001).The peak age of polyps was in preschool-age,chronic colitis and Crohn's disease occurred mostly in school-age and adolescence,and ulcerative colitis was more common in adolescence.The caecal intubation rate was 85.6%(417/487).There were no serious complications such as respiratory arrest or sudden cardiac arrest during the operation,and two cases had post-anesthetic shivering after operation.With high frequency electrosurgical coagulation,259 cases of intestinal polyps were treated with painless colonoscopic polypectomy,three cases had intraoperative intestinal bleeding,2 cases had postoperative intestinal bleeding,and two cases had perforation after operation.Conclusion Painless colonoscopy in children is a safe and effective method for the diagnosis of lower gastrointestinal diseases.Distribution of lower gastrointestinal diseases is different in children among different age groups.The high freque

关 键 词：无痛结肠镜 息肉切除术 儿童 

分 类 号：R725.7[医药卫生—儿科]