婴儿急性上消化道出血75例临床研究

The Clinical Study of Acute Hemorrhage of Upper Digestive Tract in Infant of 75 cases

目的为探讨引起婴儿急性上消化道出血的常见原因、出血程度与临床表现,以研究防治方法。方法对75例婴儿进行生命体征评估及行相应实验室检查,并进行相关影像学检查。结果维生素K缺乏症25例,占33.33%;应激性溃疡23例,占30.67%;反流性食管炎7例,占9.33%;感染性腹泻5例,占6.67%;坏死性小肠炎5例,占6.67%;肠套叠3例,占4%;多脏器功能损害3例,占4%;白血病2例,占2.67%;十二指肠憩室1例,占1.33%。伴面色苍白62例,占82.67%;全身软弱,哭声无力60例,占80%;四肢冷55例,占73.33%;少尿49例,占65.33%;神志不清28例,占37.33%;血压下降53例,占70.66%。治愈69例(84%),未愈3例(4%),死亡3例(4%)。结论婴儿急性上消化道出血病因以维生素K缺乏和应激性溃疡为主,极易出现失血性贫血和失血性休克;应采取积极治疗原发性疾病、注意喂养和及早使用维生素K为主的综合防治方法。

Objectives To explore the common cause, degree of hemorrhage and c linical manifestation of acute upper digestive tract hemorrhage in infant, and s tudy the method of prevention and treatment. Methods The vital signs of 75 cases infants with acute hemorrhage of upper digestive tract were evaluated, and they were examined by laboratory and correlated imaging methods. Results The vital s igns were: Vitamin K deficiency 25 cases (33.33%); stress ulcer 23 cases (30.67 %); reflux oesophagitis 7 cases (9.33%); infected diarrhea 5 cases (6.67%); n ecrotizing enteritis 5 cases (6.67%); intussusception 3 cases (4%); multiple o rgan damage 3 cases (4%); leukemia 2 cases (2.67%) and duodenal diverticulum 1 case (1.33%); Paleness 62 cases (82.67%); tiredness 60 cases (80%); limbs co ld 55 cases (73.33%); oliguria 49 cases (65.33%); coma 28 cases (37.33%); blo od pressure decreasing 53 cases (70.66). 69 cases were cured (84%), 3 cases unc ured (4%) and 3 cases died (4%). Conclusions The major etiological factors of acute hemorrhage of upper digestive tract in infant are vitamin K deficiency and stress ulcer. The infants showed easily hemorrhagic anemia and hemorrhagic shoc k. The patients should be treated as with positively primary disease, and have t o be carefully fed and supplemented earlier with vitamin K.