357例儿童结肠镜检查回顾性研究

A retrospective study of 357 colonoscopy in children

目的探讨结肠镜检查在儿科应用的临床价值及安全性,了解不同年龄段儿童结肠镜检查原因及检出肠道疾病分布情况。方法收集2018-01-01—2020-12-31中国医科大学附属盛京医院0~14岁于内镜中心接受肠镜检查的患儿临床资料并行回顾性分析。结果 357例患儿共计进行399次结肠镜检查,94.5%(377/399)能够完成全结肠检查,219例(61.3%)肠镜下有阳性发现,357例结肠镜检查无1例出现严重并发症。<3岁组发现疾病18例,最主要疾病为克罗恩病7例(36.8%);3~6岁组检出疾病46例(90.2%),占比最大为结肠息肉(56.9%);>6~14岁组儿童共发现疾病155例(54%),以炎症性肠病检出率最高(19.2%)。结论儿童结肠镜检查安全有效、诊断率高,具有重要的临床诊疗价值。腹泻、便血为0~6岁患儿进行结肠镜检查的主要原因,>6~14岁患儿实施结肠镜检查的原因主要依次为腹痛、腹泻;结直肠息肉是3~6岁儿童结肠镜发现主要病变,0~3岁、>6~14岁患儿以炎症性肠病为主要发现疾病。

Objective To investigate the clinical value,safety and causes of colonoscopy application in children as well as the distribution of intestinal diseases in different age groups.Methods The clinical data of patients aged < 15 years who underwent their colonoscopy in the endoscopy center at Shengjing Hospital of China Medical University between Jan.1,2018 and Dec. 31,2020 were cdlected and analyzed retrospectively. Results The terminal ileum intubation success rate was 94.5%( 377/399).A total of 219 patients( 61.3%) had a positive diagnosis under colonoscopy.No serious complications occurred during the procedures in 357 cases.The most frequent diagnosis in 0-3-year group was Crohn’s disease( 36.8%).A total of 46 cases of disease( 90.2%) were found in 3-6-year group. The most frequent diagnosis in 3-6-year group was colonic polyps( 56.9%).A total of 155 cases( 54%) were found positive diagnosis in the 7-14-year group,and the detection rate of inflammatory bowel disease( IBD) was the highest( 19.2%).Conclusion Colonoscopy in pediatric patients is a safe and effective procedure with a high diagnostic rate,and has important clinical diagnostic and therapeutic value.Diarrhea and blood in the stool are the main reasons for colonoscopy in children aged 0-6 years. The main reasons for colonoscopy in children aged 7-14 years are abdominal pain and diarrhea.Colorectal polyp is the main lesion revealed by colonoscopy in 3-6-year-old group.IBD is the main disease in children aged 0-3 and 7-14.