小儿旷置结肠炎的临床及内镜特点

Clinical and endoscopical features in division colitis in children

目的探讨小儿旷置结肠炎的临床和内镜表现特点。方法回顾分析126例小儿旷置结肠炎的临床和内镜资料,主要对43例有消化道症状和83例无消化道症状病例肠造口术后3个月前后的内镜检查结果进行对比分析。结果本组43例有腹痛、血便、粘液便等消化道症状病例,内镜检出其旷置结肠黏膜出现糜烂、溃疡、炎性息肉,阳性率高于83例无消化道症状病例(P<0.05),本组126例通过术后3个月前后内镜结果比较,内镜检出其旷置结肠黏膜糜烂、溃疡、炎性息肉阳性率,造口术后3个月高于造口术前3个月(P<0.05)。结论小儿旷置结肠炎是发生在肠造口术后结肠、直肠的非特异肠炎,发病原因目前尚不明确,内镜检查有助于该病临床早期诊断以及对症治疗。

Objective To investigate the clinical and endoscopical features of children with diversion colitis. Methods Retrospective analysis of the clinical manifestations in 126 patients with colonic diversion was done. And all of them underwent twice colonoscopies in and out 3 months after surgical diversion. Patients were divided into two groups： one with alimentary disturbance and the other one with normal gastroenterological function. Results Widespread hemorrhagic spots, erythema, erosion, ulceration and inflammatory polyps in large bowls were noted in these 126 patients. The lesions in 43 patients with abdominal pain and bleeding were severer than those of the other 83 asymptomatic patients （P〈0. 05）. The sever lesions （erosion, ulceration, polyps） mainly took place 3 months later （P〈0. 05）. Conclusions Diversion colitis is a nonspecific inflammation that occurs in segments of bypassed colonic and rectal tissue. The colonoscopy is a useful tool for the diagnosis and treatment of diversion colitis in children.