小儿消化性溃疡的临床特点及与胃镜特征关系研究

Clinical characteristics of 238 children with peptic ulcer and the relationship with endoscopic features

目的探讨小儿消化性溃疡的临床特点及与胃镜特征的关系。方法回顾性分析2011年6月至2016年1月在本院行胃镜诊断的238例小儿消化性溃疡患儿临床资料、内镜下病理特征及幽门螺旋杆菌(HP)感染情况。结果238例消化性溃疡儿童中十二指肠溃疡140例(58.82%),胃溃疡68例(28.57%),复合性溃疡30例(12.60%)。十二指肠溃疡部位主要在球前壁及大弯部位,胃溃疡部位主要在胃角及胃窦部位,复合性溃疡主要在球前壁及胃窦部分。男性患儿消化性溃疡比例与女性患儿消化性溃疡比例无统计学意义(P>0.05)。与年龄≤3岁组、4-6岁组、6-12岁组相比,12-14组儿童消化性溃疡发生比例显著升高(P<0.05)。238例小儿消化性溃疡患儿中HP(+)率为77.73%(185/238),HP(-)率为22.27%(53/238)。与HP(-)组相比,HP(+)组胃黏膜炎症活动性、胃黏膜萎缩、淋巴滤泡形成的发生率显著升高(P<0.05)。与HP(-)组相比,HP(+)溃疡直径>2.0cm的比例显著升高(P<0.05)。结论儿童消化性溃疡主要以十二指肠溃疡为主,主要集中在12-14岁儿童患儿中,与性别无关,HP感染可引起胃黏膜组织学改变,对于HP(+)儿童应予HP根治治疗。

Objective To explore the clinical characteristics of children with peptic ulcer and the relationship between endoscopic characteristics.Methods Clinical data,pathologic features and HP infection of 238 pediatric patients with peptic ulcer diagnosed were analyzed retrospectively from June 2011 to January 2016.Results 238 children with peptic ulcer,140 cases were duodenal ulcer（58.82%）,68 cases were gastric ulcer（28.57%）and 30 cases were compound ulcer（12.60%）.Duodenal ulcer mainly in the anterior wall of the ball and the greater curvature of the parts,gastric ulcer mainly in the gastric angle and antral parts,compound ulcer mainly in the anterior wall of the ball and antrum part.The proportion of peptic ulcer in the male was not significantly different from that in the female（P〈0.05）.The incidence of peptic ulcer in 12-14 children was significantly higher than that in age≤3,4-6and 6-12（P〈0.05）.The HP（＋）rate was 77.73%（185/238）and HP（-）was 18.07%（43/238）in children with peptic ulcer.Compared with HP（-）group,HP（＋）gastric mucosal inflammation activity,gastric mucosal atrophy,lymphoid follicle formation was significantly increased（P〈0.05）.The ratio of HP（＋）ulcer diameter〉2.0cm was significantly higher than that of HP（-）group（P〈0.05）.Conclusion Children with peptic ulcer mainly in duodenal ulcer,mainly in children 12to14 years of age,and gender has nothing to do.HP infection can cause gastric histological changes,for HP（＋）children should be HP radical treatment.