周期性呕吐综合征患儿的临床特征及治疗方案分析

Analysis of clinical characteristics and treatment plan in children with cyclic vomiting syndrome

目的分析周期性呕吐综合征患儿的临床特征及治疗方案。方法选取2018年9月至2019年9月我院收治的144例周期性呕吐综合征患儿为研究对象,收集其临床资料。分析患儿的临床特征、辅助检查结果及治疗方案。结果患儿发作均呈突然停止的刻板形式,临床症状以精神萎靡、无法沟通、持续恶心、无法进食等为主。伴随症状包括自主神经系统症状、神经系统症状、胃肠道症状。33例患儿呕吐物仅为胆汁,33例患儿呕吐物仅为咖啡样物。63例患儿的消化道钡餐造影显示胃动力低下;发作期不透X线标记物显示51例患儿胃肠道通过存在延迟;胃电图显示45例患儿发作期的正常节律百分比低于缓解期。患儿在对症治疗基础上接受阿米替林、赛庚啶治疗,135例症状明显缓解,治疗总有效率达93.75%,无明显严重不良反应。结论周期性呕吐综合征患儿存在胃肠动力障碍,特别是在发作期。若患儿症状严重,干扰生长发育,应采取长期预防性治疗;对于轻症患儿,在发作期可给予抗呕吐、输液等对症治疗。

Objective To analyze the clinical characteristics and treatment plan in children with cyclic vomiting syndrome.Methods A total of 144 children with cyclic vomiting syndrome treated in our hospital from September 2018 to September 2019 were selected as the research objects,and their clinical data were collected.The clinical characteristics,auxiliary examination results and treatment plan of children were analyzed.Results The onset of the children showed a rigid form of sudden stop.The main clinical symptoms were mental depression,inability to communicate,persistent nausea,inability to eat,etc.Accompanying symptoms included autonomic nervous system symptoms,nervous system symptoms and gastrointestinal symptoms.The vomitus of 33 children was bile and 33 children was coffee-like substance.Barium meal examination of digestive tract in 63 children showed low gastric motility;opaque X-ray markers showed delayed passage of gastrointestinal tract in 51 children;electrogastrogram showed that the percentage of normal rhythm in 45 children during attack was lower than that in remission.The children were treated with amitriptyline and cyproheptadine on the basis of symptomatic treatment,the symptoms of 135 cases significantly relieved,and the total effective rate of treatment was 93.75%,without obvious serious adverse reactions.Conclusion Children with cyclic vomiting syndrome have gastrointestinal motility disorder,especially in the attack stage.If the children's symptoms are serious and interfere with growth and development,long-term preventive treatment should be taken;for mild children,symptomatic treatment such as anti-vomiting and infusion can be given during the attack.