功能性便秘及其相关因素与儿童急性阑尾炎的相关性分析

Correlation analysis of functional constipation and its related factors with acute appendicitis in children

目的探索功能性便秘(FC)及其相关因素与儿童急性阑尾炎(AA)发生的相关性,为儿童AA的预防及临床诊治提供参考。方法回顾性分析2022年8月至2023年3月于空军军医大学第二附属医院儿科确诊为AA的170例患儿(AA组)的临床资料,选取同期就诊的170例非AA患儿(非AA组)作为对照。比较两组患儿的一般情况、FC发生率、FC相关症状、Bristol粪便分型、既往便秘史等差异。结果170例AA患儿中,FC的发生率为22.9%(39/170),明显高于非AA患儿的10.6%(18/170),差异有统计学意义(P<0.01);对于<4岁患儿,AA组中大便潴留比例高于非AA组(25.6%比9.3%),差异有统计学意义(P<0.05);对于≥4岁患儿,AA组中大便潴留、排便困难/疼痛的比例高于非AA组(28.2%比6.9%、29.0%比16.4%,均P<0.05)。AA组患儿既往便秘史比例高于非AA组(29.4%比14.1%)、中位便秘时长大于非AA组[0.00(0.00,1.25)月比0.00(0.00,0.00)月,均P<0.01]。AA组Bristol粪便分型低于非AA组,差异有统计学意义(P<0.01)。多因素Logistic回归分析显示,大便潴留[OR=6.186(95%CI 2.336~16.380)]及便秘时间长[OR=1.310(95%CI 1.095~1.567)]是儿童AA发生的危险因素(均P<0.05)。结论AA患儿大便潴留的发生率高于非AA患儿,平均便秘时长大于非AA患儿。大便潴留及长期便秘是儿童AA发生的独立危险因素。

ObjectiveTo explore the correlation between functional constipation(FC)and its related factors with acute appendicitis(AA)in children,so as to provide a reference for the prevention and clinical diagnosis and treatment of children with AA.MethodsA case-control study was conducted on 170 children diagnosed with AA in the Department of Pediatrics,the Second Affiliated Hospital of Air Force Military Medical University,from August 2022 to March 2023,and 170 non-AA children during the same period were selected as control objects.The clinical data,incidence of FC,symptoms related to FC,Bristol stool classification,past constipation history and other information were compared between two groups.ResultsThe incidence of FC in 170 children with AA was 22.9%(39/170),which was significantly higher than 10.6%(18/170)in the non-AA group(P<0.01);For children under four years old,the proportion of faecal retention in AA group was higher than that in non-AA group(25.6%vs.9.3%,P<0.05);For children≥4 years old,the proportion of faecal retention and dyschezia in AA group were higher than those in non-AA group(28.2%vs.6.9%,29.0%vs.16.4%,respectively,all P<0.05).The proportion of past constipation history in AA group was higher than that in non-AA group(29.4%vs.14.1%).The duration of constipation in AA group was longer than that in non-AA group[0.00(0.00,1.25)month vs.0.00(0.00,0.00)month,all P<0.01].The proportion of children with low Bristol stool classification in AA group was higher than that in non-AA group(P<0.01).Multivariate Logistic regression analysis showed that faecal retention[OR=6.186(95%CI 2.336~16.380)]and long constipation time[OR=1.310(95%CI 1.095~1.567)]were independent risk factors for AA in children(all P<0.05).ConclusionThe incidence of faecal retention in children with AA is higher than that in children without AA,and the median duration of constipation is longer than that in children without AA.Fecal retention and long-term constipation are independent risk factors for AA in children.