电子胃镜诊治儿童上消化道疾病的临床分析

Clinical Analysis of Gastroscopy in the Diagnosis of Diseases of Upper Digestive Tract

目的探讨电子胃镜诊治儿童上消化道疾病的临床应用价值。方法选择2010年7月至2012年2月在柳州市妇幼保健院门诊及住院治疗的356例上消化道疾病患儿的临床病历资料为研究对象。所有患儿均行电子胃镜检查,部分患儿行快速尿素酶检测幽门螺旋杆菌(HP),镜下病变程度严重者则进一步行组织病理学检查及改良Giemsa染色镜检(本研究遵循的程序符合柳州市妇幼保健院伦理委员会制定的伦理学标准,得到该委员会批准,并与受试对象监护人签署临床研究知情同意书)。结果 356例患儿均顺利完成电子胃镜检查,慢性浅表性胃炎为244例,胆汁反流性胃炎为34例,十二指肠球部溃疡为32例,胃溃疡为17例,复合性溃疡为4例,异物为6例(胃异物及食管异物各为3例),过敏性紫癜为5例,镜下无明显异常为4例。336例进行快速尿素酶检测HP,183例(54.46%)快速尿素酶检测呈阳性,其中56例(16.67%)行组织病理学检查结果均示慢性炎性改变。结论儿童上消化道疾病在电子胃镜下以慢性浅表性胃炎、胆汁反流性胃炎、十二指肠溃疡、胃溃疡为常见病种,HP感染与儿童胃炎及溃疡病关系较密切,儿童电子胃镜检查对儿童上消化道疾病的诊断有重要价值。

Objective To analyze and discuss the clinical value of gastroscopy in the diagnosis of diseases of upper digestive tract. Methods A retrospective analysis was carried out among 356 children who underwent gastroscopy from July 2010 to February 2012. The data including gender, age, clinical manifestations, gastroscopy diagnosis and helicobacter pylori（HP） were analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Women and Children＇s Health Care Hospital of Liuzhou City. Informed consent was obtained from all participates＇ parents. Results Among 356 cases, 244 cases of chronic superficial gastritis were found, 34 cases had bile reflux gastritis, 32 cases had bulbar ulcer, 17 cases had gastric ulcer, 4 cases had complex ulcer, 6 cases had foreign bodies （3 for esophageal foreign bodies, 3 for stomach foreign bodies）, 5 cases was henoch-schonlein purpura and 4 cases was healthy. 183 cases （54.46%） showed positive of rapid urease test. Conclusions The common upper digestive tract diseases among children are chronic superficial gastritis, bile reflux gastritis, bulbar ulcer and gastric ulcer. HP infection was related to gastritis and ulcer in children.