儿童幽门螺杆菌根除后复燃与再感染

为探讨儿童在幽门螺杆菌（H.pylori)根除后的复发情况，对90例H.pylori相关性胃十二指肠疾病，在抗H.pylori根除治疗后确定为H.pylori根除的患儿跟踪随访。结果90例儿童中复发23例，总复发率为25．56％。根除后1年内复发率为26．32％（10／38例）；根除后1年以上复发率为25．00％（13／52例），其中1年－11／2年为11．11％（2／18例）、11／2年－2年为20．22％（3／15例）、2年以上为40．11％（8／9例），P＜0．05。不同治疗方案与疗程的病例在1年内的复发率差异无显著性。H.pylori根除后1年以上，复发率呈逐步上升趋势。     

儿童再发性腹痛与幽门螺杆菌感染的关系

为探讨儿童再发性腹痛 (ＲＡＰ)与幽门螺杆菌 (Ｈｐ)感染的关系 ,我们对 13 0例ＲＡＰ患儿进行了血清Ｈｐ ＩｇＧ测定 ,观察了部分Ｈｐ阳性ＲＡＰ患儿根除Ｈｐ治疗后的治疗反应 ,现总结如下。对象和方法一、对象　 1999年 6月～ 2 0 0 1年 6月我院儿科门诊就诊的ＲＡＰ患儿 13 0例 ,男 70例 ,女 60例 ,年龄 4～ 14岁 ,病程 4个月～ 3年 ,均未经抗Ｈｐ治疗。均符合ＲＡＰ诊断标准[1] :1.腹痛病程超过 3个月 ;2 .疼痛为非特异性间断发作 ,很少表现为绞痛 ;3 .疼痛部位多在脐周、上腹或无固定范围 ,查体可有脐周压痛或无异常发现 ;4.可伴恶心、…     

疗程对儿童幽门螺杆菌感染根除率及其疗效影响

目的 研究疗程对儿童幽门螺杆菌(Hp)感染根除率及临床疗效影响。方法 183例经13C-尿素呼吸试验(C-UBT)及血清Hp-lgG证实为Hp感染腹痛患儿,男98例,女85例,年龄(6.7±2.7)岁,随机分为甲组102例,乙组81例;均接受克拉霉素15 mg／(kg·d),2;k／d;奥关拉唑0.8 mg／(kg·d),1;k／d;阿莫西林30 mg／(kg·d),3次／d,联合治疗,2组治疗方案一样,但甲组疗程1周,乙组2周。于停药后4周复查13C-UBT,了解腹痛治疗效果及Hp根除率。结果 甲组腹痛完全消失者65例,好转31例,无效6例,总有效率94.1％;乙组分别为49、30、2例,总有效率97.5％(X2=1.26 P>0.05)。甲组Hp根除率88.2％,乙组为93.8％。两组比较X2=1.68 P>0.05。结论 含奥关拉唑的三联疗法治疗儿童Hp感染,2周与1周疗程相比临床疗效及Hp根除率无明显差异,1周疗程更经济、实用。     

儿童再发性腹痛与幽门螺杆菌感染

目的 分析幽门螺杆菌(helicobacter pylori,HP)感染与儿童再发性腹痛(recurrent abdominal pain,RAP)的关系.方法 选择2010年1月至2012年6月本院儿科门诊符合RAP诊断的患儿168例,以同期因外伤疾病住院的患儿72例作为对照组.采用13C-尿素呼气试验检测Hp感染情况,并对两组患儿的临床资料进行分析.结果 Hp感染阳性率的组间比较,RAP组治疗前高于治疗后及对照组(P＜0.01),但RAP组治疗后与对照组间差异无统计学意义(P＞0.05).结论 小儿AP与Hp感染之间存在相关性,以奥美拉唑为中心的三联疗法根除方案疗效可靠.     

幽门螺杆菌感染对儿童铁营养及生长发育的影响

幽门螺杆菌（HP）感染是世界范围广泛存在且最常见的细菌感染，近年来国外研究认为，HP感染是造成或加重机体铁营养不良的因素，特别是对于铁缺乏、缺铁性贫血的危险人群。当机体处于铁营养相对不足的状态下，如果再并存HP感染，通过铁的摄入量及吸收减少、机体对铁需求增加、铁流失等机制，就会出现明显的铁缺乏及缺铁性贫血。同时，HP感染还会引起儿童生长发育迟缓。本文就HP感染对儿童铁营养状况和生长发育影响及其发病机制的研究进展作一综述。     

儿童幽门螺杆菌感染的流行病学研究

幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ）是世界各地最常见的感染性疾病病原之一,许多研究表明,Ｈｐ感染后能导致胃炎和消化性溃疡病的发生。此外,人类胃粘膜上的Ｈｐ持续存在也增加了胃癌和胃淋巴瘤发生的风险。最近从成人中获得的流行病学资料显示...     

无症状儿童人群中幽门螺杆菌感染的血清流行病学

目的 了解我国无症状儿童人群中幽门螺杆菌感染率,探讨社会经济条件等因素对Ｈｐ流行的影响。方法 采用Ｂｉｏ－Ｒａｄ ＧＡＰＩｇＧ药盒,ＥＬＩＳＡ方法检测１１１９位７－１４岁健康学生血清中Ｈｐ－ＩｇＧ抗体。结果 儿童Ｈｐ平均感染率为４０．９３〈％居住农村者为４９．８３％,居住市区者为３１．４９％。７岁组为３０．９１％,８岁为３４．９３％,９岁为３８．９２％,１０岁为４６．１１％,１１岁为４８．６７％,     

254例无症状儿童及22个家庭幽门螺杆菌感染的流行病学调查

目的 了解无症状儿童人群中幽门螺杆菌（Hp）感染率，探讨一级亲属Hp感染状况及其对儿童Hp感染的影响。方法 应用Hp尿素酶IgG抗体（ELISA）的方法检测254例4－14岁无症状儿童血清Hp-IgG抗体，并在其中选择22例已知有或无Hp感染的小儿作为标引对象，对其父母进行血清抗Hp-IgG检测。结果 小儿Hp总感染率为23．2％；4．14岁小儿Hp阳性率分别为10．5％，7．4％，13．3％，23．5％，25．0％，28．6％，25．8％，29．2％，35．4％；Hp阳性患儿的父母Hp阳性率为66．7％，Hp阴性患儿的父母Hp阳性抗率15．0％，两组差异有非常显著性（P＜0．01）。结论 小儿Hp感染具有随年龄增加而增加的总趋势，子女抗体阳性的父母的抗体阳性率显著高于子女抗体阴性的父母的抗体阳性率，提示Hp感染在家庭内有聚集现象。     

幽门螺杆菌感染对学龄前儿童铁营养状况的影响

目的 探讨Hp感染对儿童铁营养状况的影响。方法 对475名2-7岁儿童进行膳食和社会经济状况调查。外周血血细胞分析,血清铁蛋白及Hp抗体检测。对血清Hp抗体阳性者进行粪便Hp抗原测定和粪便潜血试验。结果 64名儿童感染Hp,305名儿童未感染,感染Hp儿童血清铁蛋白水平明显低于未感染Hp儿童。两组调整后的血清铁蛋白均值及95%可信区间分别为23.62μg/L（7.13μg/L-78.26μg/L）,33.48μg/L（10.28μg/L-109.06μg/L）。以非条件logistic多元回归模型有效平衡其他因素的混杂偏倚后,Hp感染仍是儿童铁缺乏的危险因素。其OR值为7.95(OR95%CI为2.56-24.67)。结论 Hp感染儿童机体铁营养水平降低。Hp感染是造成或加重儿童机体铁营养不良的独立危险因素。     

13C-尿素呼吸试验对儿童幽门螺杆菌感染根除后1年的随访

目的　探讨洛赛克、克拉霉素、阿莫西林三联根除儿童幽门螺杆菌 (Hp)感染的远近期疗效。 方法　经1 3C尿素呼吸试验 (1 3C UBT)及血清Hp IgG测定 2项阳性的反复腹痛儿 95例 ,随机分为治疗组 (60例 )与安慰剂组 (35例 ) ,治疗组接受洛赛克 0 .8mg/ (kg·d) ,每天一次 ,克拉霉素 1 5mg/ (kg·d) ,每天 2次 ,阿莫西林 30mg/ (kg·d) ,每天 3次 ,三联口服治疗 ;疗程 1周。停药后 1 ,3 ,6 ,1 2个月门诊随访 ,复查1 3C UBT及Hp IgG。 结果　 1 .治疗组停药后 4周腹痛的总有效率 96 .7% ,而安慰剂组仅 34 .6 % ;治疗组Hp根除率为 90 % ,明显高于安慰剂组 1 4 .3 %。 2 .治疗组Hp根除后 3 ,6 ,1 2个月复查Hp再感染率分别为 1 .85 %、1 .85 %、3 .57%。 结论　 1 .洛赛克等三联根除反复腹痛儿Hp感染临床效果显著 ,Hp根除率高 ,远近期疗效均好 ,1年再感染率低。2 .1 3C UBT监测Hp根除情况快捷准确。     

以家庭为中心的整体干预对骨折患儿父母心理的影响

目的探讨以家庭为中心的整体干预模式对骨折患儿父母心理状况的影响。方法采用整群抽样的方法,收集2013年1月至2015年6月收治的196例单纯四肢骨折患儿的父母作为研究对象,对照组(n=100)给予常规治疗及护理措施,干预组(n=96)在常规治疗及护理的基础上采取以家庭为中心的整体干预模式。两组家长在干预前与出院前使用SCL90症状自评量表进行评估。结果两组患儿父母组间比较无明显差别(P0.05),与全国SCL90常模比较有显著差别(P0.01);经以家庭为中心的整体干预手段后,两组患儿家长的SCL90量表评分均下降,自身前后比较有统计学意义(P0.05),且干预组与对照组比较有显著差别(P0.05)。结论四肢骨折患儿父母入院后普遍存在负面心理情绪,经不同的护理模式干预后,患儿父母的心理状况逐渐好转,其中以家庭为中心的整体干预模式能够更有效的缓解四肢骨折患儿父母的负面情绪。     

A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children

Aim: The failure rate of Helicobacter pylori ( H. pylori ) eradication imposes the assessment of new options.
Subjects and methods: A prospective open study was performed in 90 symptomatic children (range 3–18 years) with H. pylori infection, randomized in two groups: control (42 patients) and intervention group (48 patients). Both groups were treated with the standard triple eradication therapy (omeprazole/esomeprazole, amoxicillin and clarithromycin) for 7–10 days. The intervention group was also treated with Saccharomyces boulardii ( S. boulardii ), 250 mg b.i.d., for 4 weeks. The eradication rate of H. pylori was assessed by the same methods (urease test and histology) 4–6 weeks after treatment. Adverse events and compliance were evaluated after 7 and 28 days of treatment. The Chi-square test was used for statistical evaluation (p < 0.05).
Results: H. pylori infection was identified in 90 of 145 children (62%) and it correlated positively with age (p < 0.002) and inversely with socioeconomic status (p < 0.005). All infected children had chronic gastritis, with antral nodularity in 76.7%. Overall, H. pylori eradication rate was 87.7% (control 80.9%, S. boulardii group 93.3%) (p = 0.750). The incidence of side effects was reduced in the S. boulardii group: 30.9% in the control versus 8.3% in the probiotic group (p = 0.047).
Conclusion: The addition of S. boulardii to the standard eradication treatment confers a 12% nonsignificant enhanced therapeutic benefit on H. pylori eradication and reduces significantly the incidence of side effects.     

Virilization of young children after topical androgen use by their parents

Children were virilized by contact with adults using cutaneous steroid preparations. Parents were unaware of the dangers of passive transfer. Laboratory data were consistent with exogenous androgen exposure. Each child had opportunity for passive exposure, and discontinuation of contact resulted in a decrease of androgen levels or regression of symptoms.     

Failure to achieve early bacterial eradication increases clinical failure rate in acute otitis media in young children

BACKGROUND: The objective of this study was to determine the association between early bacteriologic failure and clinical failure in acute otitis media (AOM). METHODS: Children with AOM aged 3-35 months enrolled in studies documenting both bacteriologic outcomes by tympanocentesis on day 4-6 and clinical outcomes on day 11-16 (immediate posttreatment visit) constituted our study group. Bacteriologic outcomes were studied for children with AOM caused by Streptococcus pneumoniae, nontypeable Haemophilus influenzae or both. The relative risk (RR) for clinical failure of children with bacteriologic failure compared with children with bacteriologic eradication was the main outcome measure. RESULTS: Nine hundred seven episodes were analyzed. Clinical failure occurred in 7.3% of 660 patients with bacterial eradication versus 32.8% of 247 patients with bacteriologic failures. The overall RR (95% confidence interval) for clinical failure was 4.41 (95% CI: 3.19-6.11), with little variation between pathogens. After correction for age, gender, ethnic origin, previous otitis history, and previous antibiotic treatment, the rate was 6.52 (95% CI: 4.26-9.99). Across clinical studies with 8 antibiotic drug regimens for AOM, the rate of clinical failure correlated with bacteriologic failure (r = 0.8967; P = 0.003). CONCLUSIONS: In young children with culture-positive AOM, failure to eradicate the pathogen from middle ear fluid within the first few days of treatment leads to a significant risk for clinical failure.     

Improvement of the eradication rate of Helicobacter pylori gastritis in children is by adjunction of omeprazole to a dual antibiotherapy

AIM: The possible improvement of efficacy and tolerability of a 7-day dual antibiotherapy amoxicillin-clarithromycin (AC) on the eradication of Helicobacter pylori (H. pylori) gastritis in children by the adjunction of omeprazole (OAC) was studied. METHODS: Forty-six children presenting with H. pylori gastritis, assessed at inclusion by endoscopy, H. pylori urease test, histology and/or culture were randomised to a twice-daily regimen of AC or OAC. A (13)C-urease breath test was performed 4-6 weeks after the end of the treatment period to evaluate H. pylori eradication. RESULTS: A larger proportion of patients was H. pylori negative (69%) in the OAC regimen treatment 4-6 weeks after eradication treatment compared with those who received dual AC therapy (15%). A total of seven patients (three in the OAC and four in the AC group) reported adverse events (AEs). Only vomiting was reported in more than one patient (one in each treatment regimen) and only one AE was severe (urticaria: in the OAC group, but considered not related to treatment). CONCLUSION: A larger eradication rate of H. pylori was obtained in the triple OAC group than in the dual AC group. Both therapy regimens can be safely administered to children for 7 days.