中国实用儿科杂志

中国实用儿科杂志 ›› 2012, Vol. 27 ›› Issue (05): 378-380.

• 论著 • 上一篇    下一篇

小儿消化道出血174例临床分析

林    楠，闻德亮，孙    梅   

  1. 中国医科大学附属盛京医院，沈阳    110004
  • 出版日期:2012-05-06 发布日期:2012-05-30

Analysis of 174 child cases of gastrointestinal hemorrhage.

  • Online:2012-05-06 Published:2012-05-30

摘要：

目的    分析不同年龄段、不同部位小儿消化道出血的病因、定位诊断，探讨相应治疗方案。方法    对2005年1月至2008年6月中国医科大学附属盛京医院因消化道出血住院的患儿病例174例进行分组、分析，归纳总结。结果    小儿上消化道出血中以胃溃疡或十二指肠球溃疡、急性胃黏膜损伤及慢性浅表性胃炎或十二指肠球炎多见；下消化道出血中以过敏性紫癜、肠息肉和Meckel憩室或肠重复畸形合并异位胃黏膜常见。28 d至<1岁组急慢性腹泻病为最常见病因，1 ~ ＜4岁组及4 ~ ＜7岁组直结肠息肉为最常见病因，7 ~ 14岁组过敏性紫癜为最常见病因。不同年龄组间比较，牛奶过敏合并慢性腹泻，维生素K1缺乏所导致的消化道出血更常见于28 d至<1岁组，过敏性紫癜导致的消化道出血更常见于7 ~ 14岁组，其他疾病在不同年龄组间的比较差异无统计学意义。结论    对于消化道出血患儿的诊断应详细采集病史，完善胃镜，结肠镜，发射型计算机断层成像（ECT）等全面的辅助检查，积极给予补液，止血，抑酸等治疗，大部分预后良好。

关键词: 儿童, 消化道出血

Abstract:

Objective    To analyze the etiology of children with different lesions of gastrointestinal hemorrhage in different age and summarize the localization diagnostic methods，etiological diagnostic methods and corresponding treatment protocols of child gastrointestinal hemorrhage. Methods    The characters of the hospitalization cases of children with gastrointestinal hemorrhage in Shengjing Hospital from Jua.2005. to Jun. 2008 were analyzed and summarized by consulting and grouping these cases retrospectively. Results    The common etiologies of upper gastrointestinal hemorrhage were stomach or duodenal bula ulcer，acute stomach mucomembranous injury and chronic superficial gastritis in turn. The common etiologies of lower gastrointestinal hemorrhage were HSP，intestinal polyps and Meckel diverticulum or duplication of intestine with ectopic stomach mucomembrane in turn. In 28 days to one year old group，the most common etiology was acute or chronic diarrhea；in 1 ~ ＜4 years old group and 4 ~＜7 years old group，it is intestinal polyps；in 7 ~ 14 years old group，it was HSP. Comparing different age groups，CMP intolerance（with chronic diarrhea） and VitK1 deficiency were more common in 28 days to one year old group，HSP was more common in 7 ~ 14 years old group，while other diseases had no significant deviation in different age groups. Conclusion    When treating children with gastrointestinal hemorrhage，we should emphasize on collecting detailed medical histories，consummating auxiliary examinations and offering treatments in time，and most of them have good prognosis.

Key words: children, gastrointestinal hemorrhage