548例儿童的胃镜分析

Clinical analysis of 548 cases children undergoing gastroendoscopy

目的探讨7岁以上儿童上消化道疾病的临床表现特点及采用成人电子胃镜检查的安全性和镜下疾病谱。方法回顾性分析该院6年余548例患儿的临床和胃镜资料。结果548例患儿均顺利完成胃镜检查。临床表现以上腹部或脐部无规律疼痛为主,有时伴反酸、恶心、嗳气、食少和呕吐。镜下无明显异常者133例(24.3%);慢性浅表性胃窦炎255例(46.5%);胆汁反流性胃炎46例(8.4%);糜烂性胃窦炎13例(2.4%);十二指肠球部溃疡60例(10.9%);胃溃疡5例(0.9%),异物6例(1.1%);其他30例(5.5%),65例消化性溃疡幽门螺杆菌(helicobacterpylori,Hp)感染率为87.7%。结论成人电子胃镜对7岁以上儿童检查其安全性和准确性高,临床表现无特异性,镜下以慢性浅表性胃窦炎和十二指肠球部溃疡居多,正常胃黏膜像次之,消化性溃疡Hp感染率高,根除Hp后可降低其并发症的发生率和复发率。

[Objective] To study clinical characteristics of upper digestive tract disease of children aged 7-14 years, the safety of adult gastroscopic examination and the disease chart of gastroscopic examination. [Methods] The clinical dates and the results of gastroscopic examination on the 548 cases of childrenduring 1999-2005 were analyzed retrospectively. [Results] 548 cases patients had finished gastroscopic examination smoothly. It usually presented with abdominal or umbilicus no the regulation pain, sometimes had sour-reflex, nausea, hiccup, vomiting. Gastroscopy showed that chronic superficial gastritis, bile-reflex gastritis, duodenal ulcer were found in 255, 46, 60 of the 548 cases. Positive test for Helicobacter pylori （Hp） was found in 87.7% （57/65） of 65 cases peptic ulcer .[Conclusions] The adult gastroscopic examination is safe for those childres above 7 years, and the clinical characteristics were of no particularity, the most common diseases in upper digesive tract are gastritis, duodenalitis in childhood. Hp infection rate of peptic ulcer is high, after exterminating Hp can decrease its complications occurrence rate and relapsing rate.