165例儿童腹水的病因分析

Etiology of ascites in 165 children

目的 分析儿童腹水的病因及临床特点,为儿童腹水的诊治提供理论依据,减少漏诊、误诊。方法 回顾性分析2010年1月1日至2019年12月31日间住院诊断腹水患儿的临床特征。结果 165例腹水儿童,男女比例1.53∶1,平均发病年龄(6±4)岁。腹水病因依次为:外科急腹症(39例,23.6%)、感染性疾病(39例,23.6%)、肿瘤性疾病(27例,16.4%)、肝源性疾病(18例,10.9%)、胰腺炎(10例,6.1%)、心源性疾病(8例,4.8%)、风湿免疫性疾病(6例,3.6%)、肾源性疾病(5例,3.0%)等。按发病年龄分为婴儿33例,幼儿24例,学龄前期30例,学龄期41例,青春期37例。外科急腹症、肝源性疾病是引起婴儿组腹水的主要原因(P<0.05),幼儿组的首要病因是肿瘤性疾病(P<0.05),青春期组的首要病因为感染性疾病(P<0.05)。结论 外科急腹症、感染性疾病、肿瘤性疾病、肝源性疾病是儿童腹水的常见病因;不同年龄段儿童腹水的主要病因存在一定差异。

Objective To study the etiology and clinical features of children with ascites,so as to provide a basis for the diagnosis and treatment of ascites in children.Methods The medical data of the children with ascites,who were hospitalized from January 1,2010 to December 31,2019,were retrospectively reviewed.Results Among the 165children with ascites,the male/female ratio was 1.53:1,and the mean age of onset was(6±4) years.The causes of ascites included surgical acute abdomen(39 children,23.6%),infectious diseases(39 children,23.6%),neoplastic diseases(27children,16.4%),hepatogenic diseases(18 children,10.9%),pancreatitis(10 children,6.1%),cardiogenic diseases(8children,4.8%),rheumatic immune diseases(6 children,3.6%),and nephrogenic diseases(5 children,3.0%).According to the age of onset,there were 33 infants,24 young children,30 preschool children,41 school-aged children,and 37adolescents.Surgical acute abdomen and hepatogenic diseases were the main causes of ascites in infants(P<0.05).Neoplastic disease was the leading cause in young children(P<0.05).Infectious diseases were the most common cause in adolescents(P<0.05).Conclusions Surgical acute abdomen,infectious diseases,neoplastic diseases,and hepatogenic diseases are the common causes of ascites in children,and there are some differences in the leading cause of ascites between different age groups.