婴儿过敏性直肠结肠炎27例临床分析

Clinical Characteristics of Infants with Allergic Proctocolitis: A Retrospective Analysis of 27 Cases

目的 探讨婴儿过敏性直肠结肠炎的临床特点以早期诊断,提高诊治水平。方法 回顾性分析2011年12月至2014年12月我院儿科诊治的27例过敏性直肠结肠炎患儿的临床资料。结果 过敏性直肠结肠炎主要见于6个月以下的婴儿,特别是1～3个月,共15例（55.6%）,临床表现为腹泻,部分见血便18例（66.7%）,包括粘液血便和鲜血便。实验室检查患儿均检测了食物特异性Ig G抗体,阳性率前三位为牛奶24例（88.9%）,蛋清/蛋黄12例（44.4%）和大豆5例（18.5%）。所有患儿均给予饮食回避。母乳喂养患儿其母亲在哺乳期间禁食过敏原检测阳性的食物,人工喂养患儿则给予特殊配方奶粉。结论 婴儿过敏性直肠结肠炎临床表现以腹泻及血便为主,其诊断需仔细询问病史包括家族中有无特应性病史,同时需认真体检,除外导致血便的其他疾病。治疗的主要方法是饮食回避。

Objective To explore the features of infantile allergic proctocolitis in order to improve early diagnosis and treatment. Methods A retrospective analysis of clinical data from 27 infants with allergic proctocolitis who were hospitalized in pediatric department of Dujiangyan people＇s Hospital between December 2011 and December 2014. Results Allergic proctocolitis mainly occurred in infants who were under 6 months, and in totally 27 infants, 15 cases （55. 6% ） were yonger than 3 months; The main clinical manifestation was diarrhoea, and 18 cases （66. 7% ） had bloody stools with or without mucus; All of 27 infants did detection for specific IgG antibody to food, and the most common allergen were milk （24/27, 88.9%）, yolk （12/27, 44. 4% ） and soybean （5/27, 18. 5% ）. All patients were administered by avoiding allergic food. Mother breasffeeding children were required to avoid their baby＇s allergen foods and artificial feeding children were feed with special formula. Conclusion Diar- rhea and bloody stool are main clinical characteristics of Infantile allergic proctocolitis. After excluding the other diseases causing bloody stool, the diagnosis of it requires careful history inquiring including family history and careful physical examination. Avoiding allergic food is a. effective method in diagnosis and treatment.