慢性胃炎儿童胃固体排空功能研究

Gastric emptying of solids in children with chronic gastritis.

目的了解慢性胃炎患儿胃固体排空功能。方法对2008年1月至2012年1月首都儿科研究所附属儿童医院6～17岁因反复上腹部(或脐周)疼痛、上腹部不适伴有腹胀、嗳气、恶心、呕吐、早饱等消化道症状持续2个月以上,并且每周至少发作1次的儿童需要做胃镜检查者,进行电子胃镜常规检查,同时取病理活检并进行幽门螺杆菌(HP)检测。对确诊慢性胃炎的65例患儿行钡条胃固体排空试验,计算5h胃排空情况,收集服用钡条后24h的临床症状和体征。结果 HP感染总阳性率为27.7%,5h胃排空异常率HP阳性者占11.1%,HP阴性者占21.3%,两者差异无统计学意义(P>0.05)。HP阳性者无论是否有胃排空异常,其胃黏膜病理中-重度炎症者占66.7%。慢性胃炎患儿5h胃排空率<50%者占18.5%,胃排空率<75%者占23.1%。慢性胃炎患儿服用钡条后24h内均无任何异常症状和体征。结论部分慢性胃炎患儿存在胃动力障碍,临床症状不能完全反映胃固体排空情况。对于6～17岁儿童服用钡条行胃固体排空功能检查安全并符合自然生理状态。HP阳性者中-重度慢性胃炎发生率高。

Objective To study the gastric emptying of solids in children with chronic gastritis. Methods From Jan.2008 to Jan.2012 in Capital Institute of Pediatrics, the children aged 6 to 17 years with recurrent upper abdominal （or cullen）pain, upper abdominal discomfort associated with bloating, belching, nausea, vomiting, early satiety lasting for 2 months or tam＇e, and the onset more than once per week were asked to undergo electric endoscopy;65 chronic gastritis patients were enrolled. The gastric emptying was measured by a radioscopic technique 5 h after a solid meal with radiopaque markers. Results HP positive patients accounted for 27.7%. There were no significant differences between HP positive patients and HP negative patients （ 11.1% and 21.3%, respectively, P 〉 0.05 ）. Moderate and severe gastritis patients accounted for 66.7% in HP positive patients. For the postprandial 5 h emptying, 18.5% children with ehronic gastritis had less than 50% gastric emptying of solids, and 23.1% of them had less than 75% gastric emptyifig of solids. There were not any side effects of radiopaque markers in 24h in children with chronic gastritis. Conclusion Some of the children with chronic gastritis have gastro-obstraction, the clinical symptom hardly reflects the gastric emptying of solids. Radiopaque markers are safe and comply with its natural physiological state for children aged from 6 to 17. The incidence of moderate and severe gastritis is higher in HP positive patients than in mild gastritis.