儿童再发性腹痛128例的临床分析

Clinical analysis of 128 children patients with recurrent abdominal pain

目的提高对再发性腹痛的病因认识,尽早诊断,避免误诊,进而进行个体化治疗,有效缓解患儿不适,减轻家长的经济及精神负担。方法回顾性分析了郑州大学附属郑州中心医院128例再发性腹痛的患儿的病史、临床资料及实验室检查。结果128例患儿中器质性疾病占79%(101例),其中胃十二指肠炎症及溃疡占37%(48例),肠系膜淋巴结炎占18%(23例),食物不耐受及过敏性胃肠炎占15%(19例),麦克儿憩室2%(3例),克罗恩病及肠结核占5%(6例),糖尿病1%(1例),慢性阑尾炎1%(1例);功能性占21%(27例),其中精神因素占8%(10例),肠痉挛占13%(17例)。结论儿童再发性腹痛病因较多。目前器质性病变为主要病因,最常见的是肠系膜淋巴结炎、上消化道炎症及溃疡;功能性腹痛需排除所有器质性病变可能后,再行诊断。随着社会发展,影响因素发生改变,详细的病史询问、体格检查及必要的辅助检查等整体性思维,有助于腹痛患儿病因的有效分析,进而给予正确的治疗,缩短病程,避免滥用抗生素,减轻患儿及家长的精神及经济负担。

Objective To improve the understanding of the etiology of recurrent abdominal pain,early diagnosis,to avoid misdiagnosis,and then individualized treatment,effectively alleviate the discomfort of children,reduce the economic and mental burden of parents.Methods A retrospective study was carried out to analyze medical history、clinical data and laboratory findings of 128 children with RAP.Results Totally 128 cases of organic diseases accounted for 79%(101 cases),including gastric and duodenal inflammation and ulcer accounted for 37%(48 cases),mesenteric lymphadenitis accounted for 18%(23 cases),food intolerance and allergic gastroenteritis accounted for 15%(19 cases),Meckel diverticulitis accounted for 2%(3 cases),Crohn's disease and intestinal tuberculosis accounted for 5%(6 cases),diabetes mellitus in 1%(1 case),chronic appendicitis in 1%(1 case);Functional accounted for 21%(27 cases),including mental factors accounted for 8%(10 cases),intestinal spasm was 13%(17 cases).Conclusion Childrens recurrent abdominal pain causes are more o At present,organic diseases are the main causes,the most common are mesenteric lymphadenitis,upper gastrointestinal inflammation and ulcer;Functional abdominal pain should be diagnosed after all organic diseases are excluded.With the development of society,influencing factors have changed.The comprehensive thinking of detailed medical history inquiry,physical examination and necessary auxiliary examination is helpful for the effective analysis of the etiology of abdominal pain in children,so as to give correct treatment,shorten the course of disease,avoid the abuse of antibiotics,and reduce the mental and economic burden of children and their parents.