不同年龄小儿消化道出血部位及病因分析

Analysis of site and cause of gastrointestinal bleeding in children of different ages

目的探讨不同年龄小儿消化性溃疡出血部位及病因的特点。方法 2014年6月至2015年6月佛山市妇幼保健院儿科收治住院的消化道出血患儿142例,根据患儿年龄分组：3个月至1岁组34例、〉1~4岁组23例、〉4~7岁组38例、〉7~15岁组47例。比较不同年龄患儿出血部位和出血原因的差别。结果 142例患儿中上消化道出血以柏油样大便为主要临床表现,下消化道出血以鲜红色血便多见。上消化道出血69例,病因发生较高依次为食管炎、胃溃疡和十二指肠溃疡;下消化道出血73例,病因发生较高依次为过敏性紫癜、急慢性腹泻。各年龄组过敏性紫癜和急慢性腹泻发生人数比较差异有统计学意义（P〈0.05）。结论针对消化道出血的患儿应详细采集病史,上消化道出血以食管炎、胃溃疡和十二指肠溃疡为主,下消化道出血以过敏性紫癜、急慢性腹泻为主。临床上应采用多种诊疗手段进行观察并选择治疗方法。

Objective To investigate the characteristics of the bleeding site and cause of peptic ulcer in children of different ages.Methods A total of 142 children admitted to Foshan Women and Children Hospital for gastrointestinal bleeding from June 2014 to June 2015 were included in the study.They were divided into 4groups according to age：groupⅠ（34cases）aged 3months to 1year,groupⅡ（23cases）aged one year to 4years,group Ⅲ（38cases）aged 4to 7and groupⅣ（47cases）aged 7to 15.The site and cause of bleeding were compared.Results In the 142 cases,the main clinical manifestation was tarry stools,and blood stool in bright red was common in the lower gastrointestinal bleeding.There were 73 cases of lower gastrointestinal bleeding.The main cause was allergic prupura,followed by acute and chronic diarrhea.Comparing the number of cases of allergic purpura and acute and chronic diarrhea in different age groups,there was statistical difference（P〈0.05）.Conclusion For children with gastrointestinal bleeding,the detailed history should be recorded.Esophagitics,gastric ulcer and duodenal ulcer are common in upper gastrointestinal bleeding,while in the lower bleeding,allergic purpura and acute and chronic diarrhea are more commonly seen.Clinically multiple methods of diagnosis and treatment should be used to observe the disease in order to screen for the suitable treatment.