儿童炎症性肠病45例临床分析

Clinical analysis of inflammatory bowel diseases in 45 children

目的 了解小儿炎症性肠病 (IBD)的临床、X线、内窥镜及病理组织学特点 ,以提高对IBD诊断水平。方法 对 45例IBD患儿按照 1993年全国慢性非感染性肠道疾病学术研讨会制定的溃疡性结肠炎 (UC)的诊断标准及WHO对克隆病 (CD)推荐的 6个诊断要点及采用Harvey和Bradshow标准进行临床、X线、内窥镜和病理组织学分析。结果 UC 3 8例 ,克隆病 (CD) 7例。IBD以男童发病为多 ,腹痛、发热、消瘦、贫血在两组间无明显差异 ,而UC组多出现腹泻、便血 ;腹部包块及肠外表现在CD组更常见 ;上消化道病变分布仅在CD出现 ,UC以全结肠受累为主。结论 小儿IBD诊断需对临床、X线、内窥镜及病理组织学资料进行综合评价 。

Objective To investigate the features of inflammatory bowel diseases (IBD) in diagnostic aspect by analyzing the clinic data, X-ray findings, endoscope and pathohistology study of IBD.Methods According to the diagnostic criteria of ulcerative colitis (UC) that was established in national seminar about chronic non-infectious intestinal diseases in 1993,6 main diagnostic key points of Crohn′s disease recommended by WHO,Harvey and Bradshow standard, 45 patients with IBD were analyzed clinically with X-ray, endoscope and pathohistologic examination. Results Among 45 patients with IBD, 38 patients were ulcerative colitis, 7 patients were Crohn′s disease (CD). IBD was most likely to occur in boys, and there was no difference between UC and CD in frequency of abdominal pain, fever, leanness and anemia. But diarrhea, hematochezia occurred more often in UC group, abdominal mass and extraenteral manifestation in CD group. Upper digestive tract lesion presented only in CD cases; the whole colon lesion developed usually in UC cases.Conclusion Findings suggest that diagnosis of IBD in children should undertake comprehensive assessment on clinical, endoscopic, radiological and experimental data,especially based on endoscope and pathohistology study.