慢传输型便秘的诊断及治疗  

Diagnosis and treatment of slow transit constipation in children

作　　者：杨敏[1] 王宝西[2] 冯哲[1] 赵刚[1] 杨辅直[1] 李伟生[1] 钟汝玲[1] 王茂贵[2] 

机构地区：[1]武警广东总队医院儿科,广州510507 [2]第四军医大学唐都医院,西安710038

出　　处：《实用儿科临床杂志》2003年第12期969-971,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的　评价检测结肠传输时间对诊断小儿慢传输型便秘的价值 ,探讨聚乙二醇 4 0 0 0 (PEG 4 0 0 0 )治疗慢传输型便秘的疗效及安全性。方法　便秘组 4 6例 ,健康对照组 32例。应用简化的不透X线标志物法 ,测定两组结肠传输时间 (CTT)和分段结肠传输时间 ,包括右半结肠传输时间 (RCTT)、左半结肠传输时间(LCTT)和直肠乙状结肠传输时间 (RSTT)。给予全CTT延长的便秘患儿早晚 2次口服PEG 4 0 0 0 (0 .2 5～ 0 .5g/kg ,2次 /d) ,治疗 2周 ,记录排便次数和大便性状 ;停药 1周后复查CTT ,比较服药前后CTT变化。 结果　便秘组CTT、RCTT、LCTT和RSTT较对照组明显延长 (6 9.9± 13.4 )hvs (15 .2± 4 .6 )h (2 3.7± 5 .4 )hvs (7.4±2 .7)h ,(15 .4± 3.7)hvs (3.8± 2 .4 )h ,(30 .8± 6 .7)hvs (4 .0± 2 .8)h(P均 <0 .0 1)。结肠慢传输型便秘 2 4例 ,治疗前后CTT、RCTT、LCTT和RSTT分别为 (6 4 .3± 8.4 )hvs (16 .3± 3.2 )h ,(2 1.9± 4 .2 )hvs (7.8± 3.1)h ,(14 .8± 3.9)hvs (4 .4± 2 .3)h ,(2 7.6± 5 .1)hvs (4 .1± 2 .3)h ,经统计学处理有极显著差异 (P均 <0 .0 0 1)。每周排便次数由 (2 .2± 0 .4 )次增加至 (10 .7± 1.8)次 (P <0 .0 1)。 83.3%大便性状恢复正常 ,总有效率 95 .8% 。Objective To study the value of colonic transit time (CTT)in diagnosis of slow transit constipation and evaluatiry the effect of polyethylene glycol(PEG)4000 in children.Methods All the subjects involved in this study were divided into 2 groups. One group was functional constipation group,including 46 patients.The other was control group involved 32 healthy volunteers.In this study the simplified method of radiopaque markers was used to determining the total and segmental colonic transit time of the functional constipation and normal children, and in part of these patients X-ray defecography was also combined used. Patients with prolonged total CTT received PEG 4000[0.25-0.5 g/kg,tuile a day]orally for 2 weeks and CTT was measured again a week after treatment. Results The CTT,right colonic transit time(RCTT),left colonic transit time(LCTT) and rectosigmoid colonic transit time(RSTT) of constipation children were significantly prolonged than those in controls(69.9±13.4)h vs (15.2±4.6)h, (23.7±5.4)h vs (7.4± 2.7)h, (15.4±3.7)h vs (3.8±2.4)h, (30.8±6.7)h vs (4.0±2.8)h, (P<0.01,respectively). There were 24 patients diagnosed slow transit constipation according to CTT and transit index. After PEG 4000 therapy, the average CTT, RCTT, LCTT and RSTT were significantly shortened (64.3±8.4)h vs (16.3±3.2)h, (21.9±4.2)h vs (7.8±3.1)h, (14.8±3.9)h vs (4.4± 2.3)h, (27.6±5.1)h vs (4.1±2.3)h (P<0.001,respectively). The stool frequently was increased from (2.2±0.4) to (10.7± 1.8) weekly (P<0.01). PEG 4000 normalized the stool consistency in 83.3 % patients.Total effective rate is 95.8 % and adverse effective rate is 8.3 %.Conclusions The technique of measuring CTT is of practical value in diagnosis of slow transit constipation and its treatment. PEG 4000 can reduce CTT and segmental colonic transit time. It is an effective and safe agent in treatment of PEG 4000 in children with SI.

关 键 词：结肠传输时间 慢传输型便秘 儿童 诊断 聚乙二醇4000 治疗 

分 类 号：R725.7[医药卫生—儿科]