儿科消化门诊功能性胃肠疾病诊疗现状:一项单中心的临床报道  

Current situation of functional gastrointestinal disease in the pediatric gastrointestinal clinic:A clinical reportfrom single center

作　　者：邹毅 张慧华 刘波[1] 李中跃[1] ZOU Yi;ZHANG Hui-hua;LIU Bo(Department of Gastroenterology,Children’s Hospital of Chongqing Medical University,Key Laboratory of Child Development and Disorders of Ministry of Education,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院消化科儿童发育疾病研究教育部重点实验室国家儿童健康与疾病临床医学研究中心儿童发育重大疾病国家国际科技合作基地,重庆400014

出　　处：《中国实用儿科杂志》2021年第8期632-636,共5页Chinese Journal of Practical Pediatrics

摘　　要：目的了解儿科消化门诊功能性胃肠疾病(FGIDs)的诊疗现状,加深对儿童FGIDs的认知。方法应用儿童FGIDs ROMEⅣ标准对2016年6月至2019年12月在重庆医科大学附属儿童医院消化门诊就诊的0~18岁患者的临床资料进行回顾性分析。结果儿科消化门诊共纳入11810例患者,FGIDs患者2788例(23.61%),婴/幼儿组FGIDs比例为19.48%(1664/8541),儿童/青少年组FGIDs比例为34.38%(1124/3269),儿童/青少年FGIDs比例明显高于婴/幼儿FGIDs(χ^(2)=291.08,P<0.01);而在婴/幼儿(χ^(2)=24.19)、儿童/青少年(χ^(2)=12.64)及消化门诊全体患者(χ^(2)=28.86)中均发现女性FGIDs比例较男性高(P<0.01)。婴/幼儿FGIDs中最常见的为功能性便秘(49.04%);其次为婴儿排便困难(22.96%)、婴儿反流(14.00%)、功能性腹泻(10.76%)、婴儿腹绞痛(2.58%);而周期性呕吐(0.48%)、反刍综合征(0.18%)则少见。儿童/青少年FGIDs最常见的为功能性消化不良(58.98%),其次为功能性便秘(21.17%)、肠易激综合征(9.25%)、功能性恶心/呕吐(6.05%)、周期性呕吐(1.78%)、功能性腹痛(非特指,1.51%),而吞气症(0.45%)、反刍综合征(0.09%)、腹型偏头痛(0.35%)、非潴留性大便失禁(0.35%)则少见。在婴/幼儿FGIDs中,56例(3.37%,56/1664)患者有疾病重叠现象,主要为婴儿反胃(G1)、婴儿腹绞痛(G4)及婴儿排便困难(G7);儿童/青少年FGIDs中,78例(6.93%,78/1124)患者有共病现象,主要为周期性呕吐综合征、功能性恶心/呕吐、功能性消化不良、腹型偏头痛、功能性便秘。结论儿科消化门诊中,约1/4的患者实为FGIDs,儿童/青少年FGIDs更为常见。部分FGIDs具年龄、性别相关性,且存在FGIDs的重叠现象。临床医师应当重视儿童FGIDs的诊治,避免误诊误治及过度医疗。Objective To understand the current situation of functional gastrointestinal diseases(FGIDs)in pediatric digestive clinic,and to strengthen the cognition of FGIDs in children.Methods The clinical data of patients aged 0 to 18 years old in Department of Gastroenterology,Children’s Hospital of Chongqing Medical University between June 2016 and December 2019 were retrospectively analyzed by utilizing FGIDs ROMEⅣcriteria.Results A total of 11810 patients were enrolled in pediatric digestive clinic and 2788(23.61%)were FGIDs patients.The percentage of FGIDs was 19.48%(1664/8541)in the neonate/toddlers group and 34.38%(1124/3269)in the children/adolescent group.The percentage of FGIDs in children/adolescents group was significantly higher than that in neonate/toddlers group(χ^(2)=291.08,P<0.01).The percentage of FGIDs was higher in female than in male(P<0.01)in neonate/toddlers group(χ^(2)=24.19),children/adolescents group(χ^(2)=12.64)and the total patients in pediatric digestive clinic(χ^(2)=28.86).The most common type of FGIDs in neonate/toddlers was functional constipation(49.04%),followed by infant dyschezia(22.96%),infant regurgitation(14.00%),functional diarrhea(10.76%)and infant colic(2.58%).Cyclic vomiting syndrome(0.48%)and rumination syndrome(0.18%)were rare.The most common FGIDs in children/adolescents were functional dyspepsia(58.98%),followed by functional constipation(21.17%),irritable bowel syndrome(9.25%),functional nausea/vomiting(6.05%),cyclic vomiting syndrome(1.78%)and functional abdominal pain-NOS(1.51%).However,aerophagia(0.45%),ruminantion syndrome(0.09%),abdominal migraine(0.35%)and nonretentive fecal incontinence(0.35%)were rare.A total of 56(3.37%,56/1664)patients with neonate/toddlers FGIDs had an overlap of diseases,mainly infant nausea(G1),infant abdominal colic(G4)and infant defecation difficulty(G7).Seventy-eight patients(6.93%,78/1124)with children/adolescents FGIDs had comorbidity,mainly cyclic vomiting syndrome,functional nausea/vomiting,functional dyspepsia,abdominal migraine,

关 键 词：儿童 功能性胃肠病 流行病学 门诊 

分 类 号：R72[医药卫生—儿科]