小儿纤维结肠镜检查133例分析

An Analysis of 133 Cases of Fibercoloscopy in Children

探讨纤维结肠镜在小儿的应用特点。１３３例便血患儿行纤维结肠镜检查，男７４例，女５９例；年龄最小１岁，最大１４岁，平均５．８岁。均在静注氯胺酮（１ｍｇ／ｋｇ）静脉全麻下镜检。诊断直肠、结肠息肉９０例，胃肠道多发性息肉病４例，直肠血管瘤１例，巨结肠术后“Ｚ”形吻合口肉芽出血１例，慢性结肠炎１２例，全结肠未见异常２５例（其中１２例经手术证实为回肠美克尔憩室，１例为小肠内瘘，其余１２例便血原因不明）。单发息肉主要分布在乙状结肠（４６例，占５５．４％）和直肠（１９例，占２２．９％）。行息肉电切术８６例，其中１８４例电凝、电切指数均分别控制在３．０～３．５和２．５～３．０范围内，切除息肉１０３枚。全部患儿治愈。便血是小儿结肠镜检查的主要适应证。在镇静状态下镜检安全可靠，无肠穿孔等并发症的发生。

Fibercoloscopy was performed on 133 children(male 74,female 59 )with rectal bleeding. Age ranged from 1 to 14 years,with an average of 5.8 years. Ketamine(1 mg/kg)was injected intravenously for fiberscopic examination. There were rectal and colonic polyps in 90 cases,multiple polyposis in 4;rectal hemangioma in 1;bleeding of anastomosis granulation after surgery for Hirschsprung's disease in 1;chronic colitis in 12 and normal colonic findings in 2 5(including:Meckel's diverticulum in 12;small intestinal fistula in 1;and unknown cause bleeding in 12).Those with simple polypi chiefly in sigmoid(46 cases,55.4%)and rectum(19 cases,22.9%).Totally 86 underwent electrocision. The electrocoagulation index was regulated from 3.0 to 3.5 while electrotomy index from 2.5 to 3.0. 103 polypi were removed with satisfactory results. Rectal bleeding is. the main indication of fibercoloscopy in children. Fibercoloscopy procedures can be performed safely on small patients under sedation.