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目的探讨小儿再发性腹痛伴肠系膜淋巴结肿大与幽门螺杆菌(Hp)感染等的关系,观察Hp感染的再发性腹痛伴肠系膜淋巴结肿大儿童根除Hp治疗的临床情况。方法 79例再发性腹痛伴肠系膜淋巴结肿大行胃镜检查及Hp根除的患儿为研究对象,分析胃镜检查、肠系膜淋巴结超声和Hp检测结果 ,计算患儿治疗后Hp根除率,对比治疗前后患儿的肠系膜肿大淋巴结平均最大长、短径,观察治疗效果。结果 79例患儿中胃镜下诊断患有胃黏膜病变72例,占91.1%,包括慢性浅表性胃炎69例,其中伴十二直肠球炎16例、伴食管炎6例、伴胆汁返流12例;胃溃疡1例;十二指肠球部溃疡2例。所有患儿超声检查腹腔均可发现3个及以上淋巴结,在脐周部发现74例,回盲部和脐周部均发现5例。本组患儿Hp感染阳性率为96.2%(76/79),76例Hp感染患儿均完成随访治疗研究。在完成随访治疗的76例患儿中,治疗有效72例,治疗无效4例。Hp感染患儿治疗后肠系膜肿大淋巴结平均最大长径为(7.10±1.50)mm,明显小于治疗前的(13.10±2.90)mm,差异具有统计学意义(t=16.02,P=0.00<0.05);治疗后肠系膜肿大淋巴结平均最大短径为(3.00±0.60)mm,明显小于治疗前的(5.75±1.10)mm,差异具有统计学意义(t=19.13,P=0.00<0.05)。Hp感染患儿中有67例Hp根除,根除率为88.2%。结论 Hp感染及胃黏膜病变与小儿再发性腹痛伴肠系膜淋巴结肿大有关,根除Hp可显著减轻Hp感染的再发性腹痛伴肠系膜淋巴结肿大患儿的病情。
Objective To investigate the relationship between recurrent abdominal pain and meningococcal lymphadenopathy and Helicobacter pylori (Hp) infection in children with recurrent abdominal pain and Hp eradication. Methods A total of 79 cases of recurrent abdominal pain with mesenteric lymph node enlargement underwent gastroscopy and Hp eradication were enrolled. Gastroscopy, mesenteric lymph node ultrasonography and Hp test results were analyzed. Hp eradication rate was calculated in children with and without Hp eradication. Children’s mesenteric lymph nodes on the average maximum length, short diameter, observe the effect of treatment. Results Of the 79 cases, 72 cases of gastric mucosal lesions were diagnosed by gastroscope, accounting for 91.1%, including 69 cases of chronic superficial gastritis, of which 16 cases were complicated with 12 cases of rectal inflammation, 6 cases were accompanied with esophagitis, with bile reflux 12 cases; gastric ulcer in 1 case; duodenal ulcer in 2 cases. All children underwent ultrasound examination of the abdominal cavity can be found in 3 or more lymph nodes in the umbilical found in 74 cases, ileocecal and umbilical were found in 5 cases. The positive rate of Hp infection in this group was 96.2% (76/79), and 76 children with Hp infection were followed up. Of the 76 children who completed the follow-up treatment, 72 were effective and 4 were ineffective. The mean maximum longest diameter of mesenteric lymph nodes in children with Hp infection was (7.10 ± 1.50) mm, which was significantly lower than that before treatment (13.10 ± 2.90) mm, the difference was statistically significant (t = 16.02, P = 0.00 <0.05) (3.00 ± 0.60) mm, which was significantly lower than that before treatment (5.75 ± 1.10) mm, the difference was statistically significant (t = 19.13, P = 0.00 <0.05). Hp infection in 67 children with Hp eradication, eradication rate was 88.2%. Conclusion Hp infection and gastric mucosal lesions and recurrent abdominal pain in children with mesenteric lymph nodes, eradication of Hp can significantly reduce Hp infection of recurrent abdominal pain with mesenteric lymph nodes in children with the disease.