儿童克罗恩病5例临床误诊原因分析

Clinical Analysis on Misdiagnosis of 5 Cases Crohn＇s Disease in Children

【目的】总结儿童克罗恩病（Crohn＇s disease，CD）的临床特点，分析误诊原因，提高儿童CD的诊治水平。【方法】对2008-2010年我院收治5例CD患儿的临床资料进行回顾分析。【结果】5例CD患儿中，发病至确诊时间2周至11年，4例反复误诊。起病可急可缓，临床表现为腹痛、腹泻、生长发育迟缓、发热、口腔溃疡、肛周病变等。临床分型不一。影像学改变具有一定特征性。病理改变，破坏和慢性增殖改变并存，未发现非干酪样肉芽肿。随访9～16个月，均有不同程度缓解。【结论】儿童CD临床表现具有非特异性，起病急缓不一，误诊率高，综合临床表现、影像学和实验室检查，可以减少误诊，缩短确诊时间。

[Objective]To Summarize the clinical characteristic of Crohn＇s Disease（CD） in children,and an- alyze the cause for misdiagnosis,improve the clinical diagnosis on CD in children. [Methods]Retrospective a- nalysis on the clinical data of 5 cases CD in children received by our hospital during 2008-2010. [Results]The period of 5 cases CD in children last from 2 weeks to 11 years, 4 cases repeatedly misdiagnosed, The onset may be acute or chronic , the clinical manifestations were abdominal pain, diarrhea, growth retardation, fever, mouth ulcers, perianal lesions. The clinical classification was different. The medical images had certain characteristics. Pathology change, damage and chronic multiplication/change have coexisted, non-cheese granuloma was unfounded. Follow-up after 9-16 months, 5 cases had different levels of mitigation. [Conclusion]The clinically feature of CD in children was non-specificity, slow/fast disease attack and high misdiagnosis rate; In combination with comprehensive clinical feature, iconography and laboratory examination, misdiagnosis can be reduced and the time for making definite diagnosis can be shortened.