320例小儿腹痛的胃镜检查结果分析

Clinical analysis of gastroscopy results of 320 cases of pediatric abdominal pain

目的对小儿因腹痛行胃镜检查阳性结果者结合其临床原因及症状进行病因分析。方法选取舟山市妇幼保健院2013年7月至2015年7月因腹痛于门诊就诊或收治入院的患儿320例作为研究对象,年龄在6个月~14.5岁。参照《上消化道内镜学》中的胃镜操作方法对所有患儿进行小儿电子胃镜检查,详细记录镜下病变情况及结果,同时又进行了病变处粘膜活检及幽门螺杆菌(HP)检测。结果 32(0例患儿中浅表性胃炎共检出265例,检出率为82.81%,是腹痛的主要原因,其检出率明显高于十二指肠球部炎症的检出率(18.75%),且差异具有统计学意义(X^2=20.56,P<0.05)。胃镜报告显示,浅表性胃炎的镜下特点以"胃窦小结节"为主,占47.55%,其检出率显著高于出血型(10.04%)、红斑型(42.26%)、伴糜烂型(6.42%),差异均具有统计学意义(X^2值分别为30.23、11.33、13.28,均P<0.05);HP的总体检出率为48.75%,随着胃黏膜病变程度的加深,HP检出率增高,在重度胃黏膜炎症中,高达86.67%。结论小儿腹痛以上消化道炎症和溃疡为主,HP感染是其主要病因,并且随病程加重,检出率也增高。

Objective To explore and analyze the causes of pediatric abdominal pain with positive gastroscopy results combining clinical and symptoms .Methods Totally 320 children visiting or admitted in Maternity and Child Care Hospital in Zhoushan City during the period of July 2013 to July 2015 were selected in study for abdominal pain , and their age ranged 6 months to 14.5 years.With reference to gastroscope operation method in Upper Gastrointestinal Endoscopy infantile electronic gastroscopy was performed for all cases , and microscopic lesions and results were recorded in details .At the same time stomach lesions mucosal biopsy and helicobacter pylori （ HP） test were conducted .Results Superficial gastritis was detected in 265 of 320 cases with the detection rate of 82.81%, and it was the major cause of abdominal pain.The detection rate of superficial gastritis was much higher than that of duodenal bulb inflammation （18.75%）, and the difference was significant （χ2 =20.56, P〈0.05）.Gastroscope report showed that the microscopic features of superficial gastritis gave priority to gastric antrum nodules , accounting for 47.55%, and the detection rate was significantly higher than hemorrhagic gastritis （10.04%）, erythema gastritis （42.26%）, and gastritis with erosion （6.42%）.The differences were statistically significant （χ2 value was 30.23, 11.33 and 13.28, respectively, all P〈0.05）.Overall detection rate of HP was 48.75%.With the degree of gastric mucosa lesions increasing , detection rate of HP became higher .In severe gastric mucosa inflammation , detection rate of HP was 86.67%. Conclusion The main causes of children abdominal pain are upper gastrointestinal tract inflammation and ulcers .HP infection is the major cause, and along with the course of the disease aggravating , the detection rate is increasing .