儿童食物不耐受28例误诊分析

Misdiagnosis of 28 Cases of Food Intolerance

目的分析儿童食物不耐受的临床特点、诊断方法及误诊原因。方法回顾性分析我院2017年7月—2020年7月收治的28例误诊为其他疾病的食物不耐受患儿临床资料。结果本组28例患儿表现为反复发作的阵发性哭闹、大便次数增多、大便性状改变、腹痛、腹胀,部分患儿生长发育滞后。其中14例误诊为感染性腹泻,10例误诊为胃肠功能紊乱,4例误诊为肠系膜淋巴结炎,误诊率为15.1%。采用《食物不耐受与儿童生长发育调查表》辅助诊断,确诊后均采用食物排除治疗,其中23例临床症状消失,5例临床症状明显改善。结论食物不耐受临床症状多样,且缺乏特异性,临床医师必须熟知食物不耐受的临床特征和鉴别诊断要点,并综合分析病史,以提高诊断准确率。

Objective To investigate the clinical features,diagnosis and cause of misdiagnosis of food intolerance.Methods The clinical data of 28 children with food intolerance misdiagnosed as others diseases in our hospital from July 2017 to July 2020 was retrospectively analyzed.Results The clinical symptoms of the 28 children included recurrent paroxysmal crying,increased stool frequency,changes of fecal character,abdominal pain,abdominal distention,as well as growth retardation in some children.Among the 28 cases,14 cases were misdiagnosed as infectious diarrhea,10 cases as gastrointestinal dysfunction,4 cases misdiagnosed as mesenteric lymphadenitis,and the misdiagnosis rate was 15.1%.Food Intolerance and Development of Children Association Questionnaire was used for adjunctively diagnosis.All cases were treated with intolerant food exclusion,and symptoms disappeared in 23 cases and markedly relieved in 5 cases.Conclusion The clinical symptoms of food intolerance are diverse and nonspecific.For improving the accuracy of diagnosis of food intolerance,clinicians need to be familiar with the clinical features and the key points of differential diagnosis,and to comprehensively analyze medical history.