小儿消化道出血108例临床研究.doc

小儿消化道出血108例临床研究[摘要] 目的 探讨和研究不同年龄区间的小儿消化道出血病因分布情况以及不同时间胃镜检查与阳性率之间的关系。 方法 选取2008年12月～2011年12月在本院治疗消化道出血的小儿患者108例，其中，62例为男性，46例为女性。对108例患儿采用纤维胃镜方法检查消化道出血现象，为进一步确诊对个别患儿采取剖腹检查。 结果 88例患儿诊断为上消化道出血；5例患儿诊断为小肠出血；4例患儿诊断为咽血综合征；11例患儿未检出病因。 结论 年龄较大患儿消化道出血最常见的原因是十二指肠溃疡以及胃溃疡，尽量保证在消化道出血48 h内为患儿进行纤维胃镜检查，才能得到较高的阳性率。 [关键词] 消化系统；出血；内镜；小儿 [中图分类号] R725.7 [文献标识码] A [文章编号] 1674-4721（2012）07（a）-0053-02 Clinical analysis of 108 cases of gastrointestinal bleeding in children DENG Wen HUANG Yuanhui Maternal and Child Care Service Center of Guangdong Province, Guangdong 511400, China [Abstract] Objective To explore and study the distribution of gastrointestinal bleeding in children in different age range meanwhile the relationship between the different gastroscopy time and positive rate. Methods One hundred and eight cases of pediatric patients of gastrointestinal bleeding from December 2008 to December 2011 in our hospital were selected, of which 62 cases were male, 46 cases were female. Gastroscopy was given to 108 cases to check for gastrointestinal bleeding, exploratory laparotomy was given individual children to take further confirmed. Results Eighty eight cases were diagnosed as upper gastrointestinal bleeding; five cases were diagnosed as small intestinal bleeding; four cases were diagnosed as pharyngeal blood syndrome; causes had not been detected in 11 patients. Conclusion The most common cause of gastrointestinal bleeding in older children is duodenal ulcer and gastric ulcer, the only way to get a higher positive rate is gastroscopy to children patients within 48 hours. [Key words] Digestive system; Bleeding; Endoscopic; Children 任何年龄的小儿均可发生消化道出血现象，表现为吐血和便血。小儿消化道出血原因较复杂，消化道本身疾病可以引发出血，消化道出血也可以成为全身性疾病的局部表现[1]。小儿对失血耐受较差，具有轻重不一的临床症状，有的患儿症状表现为：较大的出血量、出血速度快，能够导致致命性失血性休克现象出现；有的患儿症状表现仅为大便潜血阳性。反复出血会导致患儿出现贫血，因此一定要及时为患儿提供正确的诊断以及治疗方案[2]。本院对108例出现消化道出血现象的小儿进行胃镜检查，并对其出血病因、年龄分布以及不同时间胃镜检查与阳性率之间的关系情况进行总结，旨在研究消化道出血的病因与患儿年龄之间的关系以及选择胃镜最佳的检查时间，现报道如下： 1 资料与方法 1.1 一般资料 选取2008年12月～2011年1