儿童抗生素相关腹泻纤维结肠镜检查结果及其意义

Testing results and significance of the fiber colonoscopy in antibiotic-associated diarrhea in children

目的明确儿童抗生素相关腹泻患儿下消化道病变,诊断和鉴别诊断儿童抗生素相关腹泻。方法对2013年6∽9月18例经该院确诊为抗生素相关腹泻患儿进行纤维结肠镜检查。结果 18例抗生素相关腹泻患儿中结肠镜检查表现为结肠黏膜弥漫性充血、水肿、血管分支模糊不清或消失14例,散在阿弗他溃疡、周围绕以红晕3例,散在糜烂溃疡及出血1例,未见假膜性肠炎表现。病变部位：乙状结肠及直肠9例,结肠脾曲及降结肠2例,横结肠3例,结肠肝曲及升结肠4例。18例患儿均行结肠黏膜活检术,镜下检查为非特异性炎性变化。结论儿童抗生素相关腹泻结肠镜检查表现均为非特异性炎性变化。儿童结肠镜检查安全、快速,在儿童抗生素相关腹泻的诊断及鉴别诊断中具有十分重要的作用,值得推广应用。

Objective To define the changes of the gastrointestinal tract of antibiotic-associated diarrhea（AAD） in chil-dren,diagnose and differentiate antibiotic-associated diarrhea in children. Methods Eighteen children,who were diagnosed with antibiotic-associated diarrhea were examined by fiber colonoscopy from June to September of 2013. Results 18 AAD children showed diffuse edema of colonic mucosa,vascular branching blurred or disappeared in 14 cases,scattered aphthous ulcers around to flush in 3 cases,scattered in 1 case of bleeding ulcers and erosions,no pseudomembranous colitis performance. Lesions：the sigmoid colon and rectum in 9 cases,splenic flexure and descending colon in 2 cases,transverse colon in 3 cases,hepatic flexure of colon and ascending colon in 4 cases. 18 children with AAD all underwent colonic mucosa biopsy with endoscopic non-specific inflammatory changes. Conclusion Colonoscopy performance of AAD children are non-specific inflammatory changes. Children colonoscopy is safe and fast,and it has a very important role in the diagnosis and differential diagnosis of AAD in children,which is worthy of promotion.