西安市0~4岁儿童功能性便秘患病特征及危险因素分析  

Characteristics and risk factors of functional constipation in children aged 0-4 years in Xi′an

作　　者：李唐 黄俊杰 尚磊 江逊 林燕 刘向增 郭宏伟 张伟 王宝西 Li Tang;Huang Junjie;Shang Lei;Jiang Xun;Lin Yan;Liu Xiangzeng;Guo Hongwei;Zhang Wei;Wang Baoxi(Department of Pediatrics,Tangdu Hospital of Air Force Medical University,Xi′an 710000,China;Department of Statistics,Air Force Medical University,Xi′an 710000,China)

机构地区：[1]空军军医大学唐都医院儿科,西安710000 [2]空军军医大学统计学教研室,西安710000

出　　处：《中华儿科杂志》2022年第7期647-654,共8页Chinese Journal of Pediatrics

摘　　要：目的调查西安市0~4岁儿童功能性便秘(FC)的患病特征及危险因素。方法2020年10月至2021年6月采取现况调查的方法,应用分层抽样方法,以西安市0~4岁2615名儿童为调查对象,采用基于罗马Ⅳ诊断标准设计的FC相关因素调查问卷进行调查。根据罗马Ⅳ诊断标准将研究对象分为FC组及非FC组,分析FC患病率及症状体征的分布情况,并应用多因素Logistic回归分析各年龄段儿童FC的危险因素。结果共发放问卷2985份,回收2711份,回收率90.8%,其中有效问卷2615份,有效率96.5%;男童1338名(51.2%),女童1277名(48.8%);FC组260例,非FC组2355名,西安市0~4岁儿童FC患病率为10.6%。不同年龄、性别儿童间FC患病率差异均有统计学意义(χ^(2)=14.58、4.39,均P<0.05),而城乡儿童之间FC患病率差异无统计学意义(χ^(2)=3.29,P=0.070)。FC组儿童以近1个月排粗大粪便史(73.5%,191/260)及排便痛苦或排干硬粪便史(65.8%,171/260)为主要症状,FC组近1个月粪便Bristol分型1、2、3型及排便抗拒、排便时间延长、腹部疼痛及排便不净感的出现率均明显高于非FC组,差异均有统计学意义(均P<0.05)。父母幼年便秘史(OR=2.13,95%CI 1.55~2.92)、近1个月出现发热(OR=1.86,95%CI 1.32~2.63)、既往便秘史(OR=3.24,95%CI 2.46~4.26)、近1个月服用益生菌(OR=1.45,95%CI 1.11~1.91)为0~4岁儿童FC的危险因素。对各年龄段进行单独分析,添加辅食早于5月龄或晚于6月龄(OR=2.42,95%CI 1.13~5.20)、添加辅食期间出现粪便干燥(OR=11.27,95%CI 5.15~24.66)、既往便秘史(OR=2.29,95%CI 1.23~4.29)、近1个月内服用益生菌(OR=1.88,95%CI 1.10~3.23)为0~<1岁婴儿FC的危险因素,母乳喂养(OR=0.53,95%CI 0.29~0.94)为0~<1岁婴儿FC的保护因素;家庭成员近期便秘史(OR=2.02,95%CI 1.06~3.85)及既往便秘史(OR=3.06,95%CI 1.74~5.38)为1~<2岁儿童FC的危险因素;父母幼年便秘史(OR=3.12,95%CI 2.00~4.85)、蔬菜类进食频率低于3次/周(OR=3.28,95%CI 2.00~5.38)、既往便秘�Objective To investigate the epidemiology,characteristics and risk factors of functional constipation(FC)in children aged 0-4 years in Xi′an.Methods From October,2020 to June,2021,a prevalence survey was conducted among 2615 children aged 0-4 years in Xi′an by group sampling.The related factors of FC were investigated by questionnaire designed based on RomeⅣdiagnostic criteria.The children were divided into FC group and non-FC group.The prevalence,symptoms and signs of FC were analyzed,and its risk factors were analyzed by multivariate Logistic regression.Results A total of 2985 valid questionnaires were handed out,and 2711(90.8%)were received back.A total of 2615 questionnaires were valid,with an effective rate of 96.5%.There were 1338 males(51.2%)and 1277 females(48.8%).There were 260 cases in FC group and 2355 cases in non-FC group.The prevalence of FC in children aged 0-4 years in Xi′an was 10.6%.There were significant differences in FC prevalence among children of different ages and sex(χ2=14.58,4.39,both P<0.05),but not in urban or rural residence(χ2=3.29,P=0.070).The main symptoms of FC group in the last month were large-diameter feces(73.5%,191/260),painful defecation or dry and hard defecation(65.8%,171/260).In the last month,FC group had higher incidences of the Bristol type 1,2 and 3 stool,fecal retention,prolonged defecation,abdominal pain and incomplete defecation compared with non-FC group,with statistical significance(all P<0.05).Parental history of childhood constipation(OR=2.13,95%CI 1.55-2.92),fever in the last month(OR=1.86,95%CI 1.32-2.63),history of constipation(OR=3.24,95%CI 2.46-4.26)and taking probiotics in the last month(OR=1.45,95%CI 1.11-1.91)were risk factors of FC in children aged 0-4 years.Stratified with age,the results showed that complementary feeding earlier than 5 months of age or later than 6 months of age(OR=2.42,95%CI 1.13-5.20),dry stools during the complementary feeding(OR=11.27,95%CI 5.15-24.66),history of constipation(OR=2.29,95%CI 1.23-4.29)and taking probiotic

关 键 词：便秘 患病率 儿童 问卷调查 

分 类 号：R725.7[医药卫生—儿科]