慢性腹痛患儿C^(13)-尿素呼气试验与胃镜检查的临床意义

Clinical significance of C^(13) breath test detection and endoscopy in children with chronic abdominal pain

目的了解慢性腹痛患儿幽门螺杆菌(H.pylori)的感染状态及幽门螺杆菌感染患儿内镜下表现的特点。方法应用C13尿素呼气试验,对905例以慢性腹痛为主要症状的患儿进行检测,对C13呼气试验阳性者进行电子胃镜检查。结果905例慢性腹痛患儿中H.pylori呈阳性185例(20.44%),随年龄增长,其H.pylori阳性率升高,学年组已达高峰。对H.pylori阳性者进行胃镜检查结果显示十二指肠隆起病变47例占25.40%,结节性胃炎41例占22.1%,慢性浅表性`胃炎38例占20.5%,结节性胃炎伴十二指肠隆起病变23例占12.43%,十二指肠球部溃疡23例占12.4%。胃溃疡7例,占3.7%(其中包括1例复合性溃疡),结节性胃炎伴十二指肠炎6例,占3.2%。结论H.pylori感染为小儿慢性腹痛的主要原因之一,也是导致慢性胃炎及消化性溃疡的主要原因之一。C13尿素呼气试验方便,快速,无痛苦,无放射性,是一较好的H.pylori检测方法;对既有消化道症状同时C13呼气试验阳性者进行胃镜检查能够协助临床诊断及治疗。

Objective To understand the infection of Helicobacter pylori（H.pylori） in children with chronic abdominal pain and its endoscopic features.Method C^13 urea breath test was applied to 905 cases of children with chronic abdominal pain as the main symptom.Electronic endonscopy was used to children whose C^13 breath test result was positive.Result Among the 905 cases,185 cases were H.pylori-positive（20.44%）,with the positive rate increasing along with age and reaching peak value at school age.The endoscopy showed there were 47（25.40%） cases of duodenal elevated lesions,41（22.1%） cases of nodular gastritis,38（20.5%） cases of chronic superficial gastritis,23（12.43%） cases of nodular gastritis with duodenal elevated lesions,23（12.4%） cases of duodenal ulcer.7（3.7%） cases of gastric ulcer（including 1 case of complex ulcer）,and 6（3.2%） cases of nodular gastritis with duodenitis.Conclusion H.pylori infection is one of the main causes of chronic abdominal pain in children,which also leads to chronic gastritis and peptic ulcer.C^13 breath test is an easy,fast,painless and non-radioactive way to detect H.pylori.Endoscopy can assist in clinical diagnosis and treatment of patients with both gastrointestinal symptoms and positive C13 breath test result.