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目的分析不同年龄段、不同部位小儿消化道出血的病因、定位诊断,探讨相应治疗方案。方法对2005年1月至2008年6月中国医科大学附属盛京医院因消化道出血住院的患儿病例174例进行分组、分析,归纳总结。结果小儿上消化道出血中以胃溃疡或十二指肠球溃疡、急性胃黏膜损伤及慢性浅表性胃炎或十二指肠球炎多见;下消化道出血中以过敏性紫癜、肠息肉和Meckel憩室或肠重复畸形合并异位胃黏膜常见。28d至<1岁组急慢性腹泻病为最常见病因,1~<4岁组及4~<7岁组直结肠息肉为最常见病因,7~14岁组过敏性紫癜为最常见病因。不同年龄组间比较,牛奶过敏合并慢性腹泻,维生素K1缺乏所导致的消化道出血更常见于28d至<1岁组,过敏性紫癜导致的消化道出血更常见于7~14岁组,其他疾病在不同年龄组间的比较差异无统计学意义。结论对于消化道出血患儿的诊断应详细采集病史,完善胃镜,结肠镜,发射型计算机断层成像(ECT)等全面的辅助检查,积极给予补液,止血,抑酸等治疗,大部分预后良好。
Objective To analyze the etiology, location and diagnosis of gastrointestinal bleeding in children of different age and different parts and to explore the corresponding treatment plan. Methods A total of 174 cases of children admitted to Shengjing Hospital of China Medical University from January 2005 to June 2008 were enrolled, analyzed and summarized. Results upper gastrointestinal bleeding in children with gastric ulcer or duodenal ulcer, acute gastric mucosal injury and chronic superficial gastritis or duodenal inflammation more common; lower gastrointestinal bleeding with allergic purpura, intestinal polyps And Meckel diverticulum or intestinal deformity with ectopic gastric mucosa common. Acute and chronic diarrhea was the most common cause between 28 days and <1 year old. Polyps of colorectal polyps were the most common cause in patients 1 ~ <4 years old and 4 ~ <7 years old, and allergic purpura was the most common cause in 7 ~ 14 years old group. Compared with different age groups, milk allergy with chronic diarrhea, vitamin K1 deficiency caused by gastrointestinal bleeding more common in the 28d to <1 year old group, caused by allergic purpura gastrointestinal bleeding is more common in the 7 to 14 age group, other diseases There was no significant difference between different age groups. Conclusions The diagnosis of children with gastrointestinal bleeding should be carefully collected history, complete gastroscopy, colonoscopy, echocardiography (ECT) and other comprehensive auxiliary examination, and actively give rehydration, hemostasis, acid suppression and other treatment, most of the prognosis is good.