小儿便血全麻下成人型结肠镜诊治

Diagnosis and treatment by adult colonoscopy under general anesthesia in children with hematochezia

目的:探讨使用成人型结肠镜对全身麻醉下便血患儿进行同步病因诊断和治疗的临床应用价值。方法:回顾性对40例便血患儿全麻下的成人型结肠镜检查和治疗资料进行分析。结果:全部患儿顺利进行了诊断及治疗,37例明确诊断,确诊率为92.5%。病变以大肠息肉最多为30例,炎症病变6例,大肠钩虫症1例。大肠息肉全部分布于直肠和乙状结肠,分别为22例及8例。除1例直肠息肉"自截"脱落遗留残根外,其余息肉全部一次性高频电圈套摘除。术后即发出血1例,迟发出血1例。麻醉意外1例。术后随访,1例多发性息肉患儿术后1年余复发。结论:成人型结肠镜应用于2岁以上小儿是安全可靠的,且具诊断和治疗双重作用。

Objective： To evaluate the diagnosis and treatment of adult colonoscopy under general anesthesia for pediatric patients with synchronous hematochezia.Methods： A retrospective review of 40 patients with hematochezia under general anesthesia in children by mean of adult colonoscopy screening,and treatment information were analyzed. Results： All patients had successful diagnosis and treatment,37 cases were diagnosed correctly,the rate was 92.5%.Lesions of colorectal polyps were most in up to 30 cases,inflammatory lesions in six cases and colorectal hookworm disease in one.Distribution of all colorectal polyps in the rectum and sigmoid colon were 22 cases and 8 cases.Apart from one cases of rectal polyp ＂chela＂ shedding legacy root,others were taken one-time polyps high-frequency trap removal.Bleeding is issued postoperatively in one,delayed bleeding in one,narcotic accident in one.Postoperative followup one patient with multiple polyps was recurrent more than a year.Conclusion： Adult colonoscopy for more than two-year-old children is safe and reliable,and has dual role of diagnosis and treatment.