儿童功能性便秘症状复现率调查及其风险因素分析

Survey of the for recurrence of functional constipation in pediatric patients and analysis of the risk factors

目的调查儿童功能性便秘症状复现发生率,探讨其与可能风险因素之间的关系。方法选择2020年1月至2021年2月在上海市儿童医院消化科及内镜中心门诊就诊并达到临床痊愈的功能性便秘患儿121例,采用问卷调查的方法,对患儿一般人口学特征、确诊日期、临床治愈日期、停药后症状复发日期、首次复发日期、各风险因素暴露情况进行相关研究。结果其中71例(58.7%)患儿在1年内便秘复发,单因素回归分析显示儿童功能性便秘复发可能的危险因素为基线年龄、过敏史、便秘家族史、挑食、1年内感冒史、抗生素使用史等。多因素COX回归分析显示,基线年龄(RR=2.093,P=0.029)、1年内感冒史(RR=2.226,P=0.037)、监护人受教育程度(RR=2.556,P=0.003)、家庭月收入(RR=2.353,P=0.011)等因素与复发的关联经多元回归筛选后仍有统计学意义。结论儿童功能性便秘与基线年龄、感冒史、监护人受教育程度和家庭月收入等因素密切相关。应根据其危险因素进行早期干预,减少复发的可能性。

Objective To study the epidemiology and some of the risk factors for recurrence of childhood functional constipation(FC).Methods One hundred and twenty-one children with functional constipation were selected,who were admitted to the Digestive Specialist Clinic of Shanghai Children’s Hospital and were clinically cured.We used a questionnaire concerning general demographic characteristics,date of confirmation,date of clinical cure,symptom recurrence after drugs withdrawal,date of first recurrence,exposures of the various categories of risk factors is identified.Results The rate of recurrence within one year was 58.7%.The risk factors for recurrence of functional constipation in children were analyzed by univariate regression analysis.The significant risk factors for recurrence of functional constipation in children analyzed were age,history of allergy,family history of constipation,picky eating,history of colds in one year,history of antibiotic use and so on.After multivariable Cox regressicn analysis found that the risk factors for recurrence of functional constipation were age(RR=2.093,P=0.029),history of colds in one year(RR=2.226,P=0.037),guardian's education level(RR=2.556,P=0.003),family monthly incom(RR=2.353,P=0.011).Conclusion The functional constipation in children is closely related to baseline age,history of colds,guardian's education level,family monthly incom and so on.Early intervention can be carried out based on its risk factors,so as to reduce the possibility of recurrence.