消化系统疾病

972172一患儿食管异物22天取出麻醉体会/周建珍刀福建医药杂志一1996,18(4).一127一128 972173小儿上消化道异物及内镜处理/许国铭…//中华儿科杂志一1996,34(5)一304一305 为提高小儿上消化道异物的诊治水平,自1981年始将纤维胃镜用于该病的诊断和治疗,至1995年底共为71例上消化道异物患儿做了内镜诊断与治疗,年龄为生后当日一12岁。68例患儿在内镜直视下成功取出了各类异物,无1例有并发症。4岁以下小儿须作静脉麻醉,术中需严密监测呼吸及血氧饱和度;5岁以上儿童可仅作咽喉麻醉。良好的器械与熟练的内镜技术是能否成功取出异物的关键。临床…     

内镜在小儿上消化道异物中的应用价值

目的探讨内镜在小儿上消化道异物中的诊断和治疗价值。方法取自2002年1月-2005年12月我院收治的42例异物摄入患儿。年龄6个月-9岁。摄入的物体包括硬币、戒指、钥匙、铁钉、鱼刺、纽扣、核桃果、回形针、围棋子、蜡烛、槟榔等，选用Olympus GIF—XQ230电子胃镜和相关器械对42例上消化道异物患儿做内镜检查和治疗。结果食管6例，胃内26例，幽门管3例（并引起嵌顿2例）、十二指肠7例。37例患儿在内镜直视下成功取出各类型异物，分别采用活检钳、鳄鱼钳、圈套器、网篮、鼠齿钳等，2例特殊异物在静脉麻醉下顺利取出，自然排出3例，无一例有严重并发症。结论经内镜取出上消化道异物是一种创伤小、安全可靠、简单有效的方法。特殊异物在静脉麻醉配合下行内镜检查及治疗会更安全。     

消化内镜在儿童消化道异物治疗的应用

目的 探讨胃镜和结肠镜在儿童消化道异物的诊断和治疗价值。方法 对８９例小儿消化道异物患儿作了内镜检查和治疗。结果 ６５例患儿在内镜直视下成功取出各类型异物,无一例有并发症。所有患儿均未全身麻醉或静脉麻醉。结论 应用内镜处理小儿消化道异物,安全可靠,有效,方便值得推广。     

消化内镜在儿童消化道异物治疗的应用

目的　探讨胃镜和结肠镜在儿童消化道异物的诊断和治疗价值。方法　对89例小儿消化道异物患儿作了内镜检查和治疗。结果　65例患儿在内镜直视下成功取出各类型异物,无一例有并发症。所有患儿均未全身麻醉或静脉麻醉。结论　应用内镜处理小儿消化道异物,安全可靠、有效、方便,值得推广。     

小儿上消化道内窥镜检查40例分析

我院自1974年1月至1985年6月期间共进行13岁以下小儿上消化道内镜检查40例,占同期内镜检查的0.1%,受检原因:上腹痛、上消化道出血、误吞异物等。十二指肠球部病变是小儿上腹痛和出血的主要原因。除1岁以下小儿须用专用内镜外,2岁以上即可使用成人细径内镜检查。异物取出等治疗性检查可用全麻,诊断性检查仅咽部局麻即可。本组病例未发生任何并发症。内镜检查对小儿上消化道疾病的诊断与治疗具有重要意义,值得推广使用。     

急诊取婴儿上消化道异物回顾性分析

目的探讨急诊内镜下取婴儿上消化道异物的方法及预防措施。方法回顾性分析2010年至2014年我科因上消化道异物行急诊胃镜治疗的患儿资料,选取1岁以内年龄段病例进行归纳分析。结果共行婴儿急诊上消化道异物取出术16例,成功取出14例,10例异物在食管,4例在胃内,2例急诊胃镜未发现异物。结论急诊内镜治疗婴儿上消化道异物安全、有效,值得临床推广。     

消化内镜在小儿消化道异物诊疗中的应用

近年来由于小儿消化内镜技术不断提高和普及，内镜诊疗消化道异物取得满意效果，其诊疗价值已逐渐被认可。自1995年至今，我院外科收治消化异物患儿105例，应用小儿胃镜、结肠镜治疗消化道异物患儿57例，成功取出异物48例，现报告分析如下。     

小儿上消化道异物的内镜处理

小儿上消化道异物可发生于小儿各个时期,以婴幼儿期多见［１］。既往对于一些上消化道异物需进行外科手术治疗,近几年来,随着内镜技术和辅助器械的日益发展,大约９５％的上消化道异物可经内镜成功取出［２］。因此,内镜术已成为治疗小儿上消化道异物的首选方法［３］...     

儿童上消化道异物致消化道损伤217例回顾性分析

目的 了解儿童上消化道异物致消化道损伤的临床特点及治疗转归。方法 收集2011年1月至2016年12月行胃镜检查诊断为上消化道异物,且出现消化道损伤的217例患儿的临床资料,回顾性分析其临床特点、胃镜下表现、并发症及转归。结果 217例患儿中,1~3岁患儿占比最高（114例,52.5%）。异物以硬币最常见（99例,45.6%）,其次为硬质/尖锐食物（45例,20.7%）及金属（35例,16.1%）。消化道黏膜损伤以溃疡最多见（43.8%）,其次为糜烂（33.2%）。纽扣电池较其他异物更易引起食管穿孔（P < 0.01）。食管为最常见受损部位（207例,95.4%）。217例患儿中,24例（11.1%）并发感染;异物致穿孔患儿较异物致溃疡患儿感染发生率明显增高（P=0.003）。217例患儿中,204例（94.0%）内镜下成功取出异物。98例因黏膜损伤较重需住院治疗,予以抗感染、抑酸治疗及鼻胃管肠内营养和/或静脉营养支持治疗。10例患儿自动出院而失访,其余患儿均好转出院。结论 幼儿期为上消化道异物高发年龄段;儿童上消化道常见异物为硬币、硬质/尖锐食物及金属;纽扣电池易造成食管穿孔;消化道黏膜损伤越重继发感染率越高;内镜下异物取出术结合鼻胃管肠内营养等处理患儿预后良好。     

气管插管钳治疗小儿食管内异物15例临床分析

目的 总结利用气管插管钳取出小儿食管内异物的经验和方法.方法 1996年10月至2006年6月采用气管插管钳成功治疗15例食道异物患儿,总结治疗经验.结果 15例患儿,年龄5～9岁.11例7岁以下患儿给予全身麻醉、4例7～9岁患儿给予表面麻醉,均安全顺利取出异物.无一例出现并发症.结论 成功利用气管插管钳的特殊形状,取出小儿食管内上端异物多例,效果显著,方法简单、易行、安全.     

Book Reviews

HANDBOOK OF PEDIATRICS, by Henry K. Silver, C. Henry Kempe, Henry B. Bruyn, Vincent A. Fulginiti
ESSENTIAL MEDICAL GENETICS, 2nd edn, by J. M. Connor and M.A. Ferguson-Smith
SEVERE BEHAVIOR DISORDERS OF CHILDREN AND YOUTH, by Robert B. Rutherford, Jr, C. Michael Nelson, Steven R. Forness
PATIENT CARE IN PEDIATRIC SURGERY, by L. L. Leape
PRIMARY CARE OF THE NEWBORN, by R. W. Coen, H. Koffler
PROGRESS IN RESPIRATION RESEARCH SERIES, edited by H. Herzog: VOLUME 22: LUNG FUNCTION IN CHILDREN AND ADOLESCENTS, by A. Zapletal, M. Samanek, T. Paul
UPPER-LIMB DEFICIENCIES IN CHILDREN: PROSTHETIC, ORTHOTIC, AND SURGICAL MANAGEMENT, by D. W. Lamb, H. T. Law
POCKET GUIDE TO PEDIATRIC FRACTURES, by J. A. Ogden
CLINICAL EXAMINATION OF THE INJURED KNEE, M. Cross, K. Crichton
DIAGNOSTIC RECOGNITION OF GENETIC DISEASE, by W. Nyhan, N. Sakati     

Book Review

Organ Transplantation in Children (Perspectives in Pediatric Pathology, Volume 13) Edited by C . R. Abramowsky and R. B. Colvin Basel, Karper, 1989, 205 pages, $1 52.00.

Basel Louis P. Dehner, MD, Karger, 1989, 205 pages, $152.00. Edited by Colin L. Berry London, Springer- Wag, 1989, 830 pages, $200.00.

Metabolic Bone Disease in Children (Clinical Pediatric Series no. 6) Edited by S. Castells and L. Finberg New Krk, Marcel Dekker, 1990, 408 tagel, $99.75.

New York Peter Revell, Marcel Dekker,1990, 408 pages, $99.75. Edited by S. Castells and L. Finberg New Krk, Marcel Dekker, 1990, 408 tagel, $99.75.     

Book Reviews

ACNE AND ROSACEA, 2nd edition, by G. Plewig and A. M. Kligman
PAEDIATRIC GASTROENTEROLOGY, edited by J. Navarro and J. Schmitz
BREAKING OUT, edited by R. Kosky, H. S. Eshkevari and G. Kneebone.
LEONARDO DA VINCI THE ANATOMY OF MAN, by M. Clayton
EFFECTIVE CARE OF THE NEWBORN INFANT, edited by J. C. Sinclair and M. B. Bracken
PRINCIPLES AND PRACTICE OF DERMATOLOGY, 3rd edition, by H. Rotstein
CHILDREN AND COUNSELLING, by M. Crompton
PAEDIATRIC HANDBOOK, 4th edition, edited by staff, Royal Children's Hospital, Melbourne
MUSCLES, MASSES & MOTION. THE PHYSIOLOGY OF NORMALITY, HYPOTONICITY, SPASTICITY & RIGIDITY, by E. G. Walsh
HEALTH FOR ALL CHILDREN, 2nd edition, edited by D. M. B. Hall     

BOOK REVIEW

Kozlowski PB, Snider DA, Vietze PM, Wisniewski HM, eds. Brain in Pediatric AIDS (Proceedings of the Conference on Brain in Pediatr HIV Infection, New York, July 24–25, 1989). Basel: Karger, 1990.
Philip A. Mackowiak, ed, Fever–Basic Mechanisms and Management. New York: Raven Press, 1991.
Pediatric Allergy and Immunology. Copenhagen: Munksgaard. Four issues per year.
Siegel M, ed. Pediatric Ultrasonography. New York: Raven Press, 1990.
Amir N, Rapin I, Branski D, eds. Pediatric Neurology: Behaviour and Cognition of the Child with Brain Dysfunction. In: Pediatric and Adolescent Medicine, Vol. 1. Basel: S. Karger AG, 1991.
Gorlin RJ, Cohen MM, Levin LS, eds. Syndromes of the Head and Neck. 3rd ed. Oxford Monographs on Medical Genetics No. 19. Oxford: Oxford University Press 1990.     

Book Reviews

Book reviewed in this article:
SEA STINGERS, by L. Marsh and S. Slack-Smith. Perth: Western Australian Museum
COMMUNITY CHILD HEALTH: AN AUSTRALIAN PERSPECTIVE, edited by G. Vimpani and T. Parry
LOSS OF A BABY: UNDERSTANDING MATERNAL GRIEF, by M. Nicol
AN ANNOTATED BIBLIOGRAPHY: ABORIGINAL HEALTH, by N. Thomson and P. Merrifield
LIFE AFTER LOSS: GETTING OVER GRIEF, GETTING ON WITH LIFE, by Francis MacNab
COLOR ATLAS OF CHILD SEXUAL ABUSE, by D. L. Chadwick, C. D. Berkowitz, D. Kerns
YEAR BOOK OF PEDIATRICS 1989, edited by F. A. Oski and J. A. Stockman III
ADVANCES IN PEDIATRICS, VOL. 35, edited by L. A. Barness, D. C. DeVivo, G. Morow III, F. Oski and A. M. Rudolph
CURRENT PROBLEMS IN PAEDIATRICS, edited by J. D. Lockhart
HANDBOOK OF HAEMATOLOGICAL INVESTIGATIONS IN CHILDREN, by R. F. Stevens
FAMILY MEDICINE: PRINCIPLES AND PRACTICE, 3rd edn, edited by J. L. Buckingham, E. P. Donatelle, T. A. Johnson Jr and J. E. Scherger
CURRENT PROBLEMS IN SURGERY, by M. M. Ravitch and F. M. Steichen
CLINICAL NUTRITION IN PAEDIATRIC DISORDERS, by D. Bentley and M. Lawson
CORE TEXTBOOK OF PEDIATRICS, 3rd edn, by R. Kay, F. A. Oski and L. A. Barness
HANDBOOK OF RENAL INVESTIGATIONS IN CHILDREN, by C. M. Taylor and S. Chapman
PAEDIATRIC NEUROLOGY—PRINCIPLES AND PRACTICE, by K. F. Swaiman     

Stellungnahme zur Verwendung von Säuglingsnahrungen auf Sojaeiweißbasis

Ohne ZusammenfassungErnährungskommission der Deutschen Gesellschaft für Kinder- und Jugendmedizin: H. J. Böhles, C. Fusch, O. Genzel-Boroviczeny, J. Henker, B. Koletzko (Vorsitzender), M. Kersting (Gast), M. Lentze, R. G. Maaser, F. Manz, W. Mihatsch, F. Pohlandt, H. Przyrembel (Gast)Ernährungskommission der Schweizerischen Gesellschaft für Pädiatrie: C. P. Braegger (Präsident), P. Baehler, O. Baenziger, D. Belli, G. Deleze, R. Furlano, J. Laimbacher, M. Roulet, J. Spalinger, P. Studer     

Book Reviews

Book reviewed in this article:
RECOGNIZING PATTERNS OF OCULAR CHILDHOOD DISEASES, by Leonard B. Nelson, Gary C. Brown, Juan J. Arentsen
THE CHROMOSOMES AND THEIR DISORDERS: AN INTRODUCTION FOR CLINICIANS, 4th edn, by G. H. Valentine
RELATED SERVICES FOR HANDICAPPED CHILDREN, by Morton M. Esterson and Linda F. Bluth
PERSPECTIVES IN PAEDIATRIC PATHOLOGY, Series Editors: Harvey S. Rosenberg and Jay Bernstein, Volume 9: NEOPLASIA IN INFANCY AND CHILDHOOD, edited by Harvey S. Rosenberg, Jay Bernstein and William A. A. Newton Jr
PEDIATRIC NEPHROLOGY, 2nd edn, edited by M. Holliday, T. Barratt and R. Vernier
CANCER IN CHILDREN: CLINICAL MANAGEMENT, 2nd edn. edited by P. A. Voute, A. Barrett, H. J. G. Bloom, J. Lemerle and M. K. Neidhardt     

BOOK REVIEWS

ABSTRACT. Eveleth PB, Tanner JM. Worldwide Variation in Human Growth , 2nd ed. Cambridge: Cambridge University Press, 1990.
Barkovich JA, Truwit LC. Practical MRI Atlas of Neonatal Brain Development. New York: Raven Press, 1990.
Ichikawa I, ed. Pediatric Textbook of Fluids and Electrolytes. Baltimore: Williams & Wilkins, 1990.
Advances in Pediatrics, vol 37. Barness LA, ed., De Vivo DC, Morrow III G, Oski F, Rudolph AM, assoc. eds. Chicago: Mosby Year Book, 1990.     

脐血造血调节因子活性的研究

探讨脐血中造血调节因子含量、来源及其与造血细胞间的关系。方法：双抗夹心酶联免疫吸附（ELISA）法和细胞因子依赖细胞株增殖反应MTT法测定脐血和脐血细胞培养上清中颗粒细胞集落刺激因子（G－CSF）、颗粒-巨噬细胞集落刺激因子（GM－CSF）、白细胞介素-6（IL－6）和肿瘤坏死因子-α（TNFα），并观察脐血造血调节因子与脐血CFU-GM、MNC、WBC相关关系。结果：正向造血调节因子G-CSF、GM－CSF和IL－6的含量明显高于成人外周血，负向调节因子TNFα测不出；脐血G－CSF、GM－CSF分别和WBC、CFU-GM成正相关，IL-6与CFU-GM成负相关，脐血、外周血和骨髓单个核细胞（MNC）培养上清液中G－CSF、IL－6产量相近,而脐血MNC培养上清中GM－CSF产量低于外周血和骨髓。结论：脐血浆有较高正向造血刺激活性，维持着胎儿高水平造血；脐血细胞自身不产生大量细胞因子。胎盘很可能是脐血细胞因子的重要来源之一。     

Book Reviews

Book reviewed in this article:
BEYOND SEPARATION. Further Studies of Children in Hospital, edited by David Hall and Margaret Stacey
MANUAL OF PEDIATRIC ANESTHESIA, by David J. Steward
PEDIATRIC NEUROMUSCULAR DISEASES, by Kenneth F. Swaiman and Francis S. Wright
CHILDREN WITH CANCER. A HANDBOOK FOR FAMILIES AND HELPERS, by Merren Parker and David Mauger
A COLOUR ATLAS OF ENDOCRINOLOGY, by Reginald Hall, David Evered and Raymond Greene
INBORN ERRORS OF IMMUNITY AND PHAGOCYTOSIS, edited by F. Guttler, J. W. T. Seakins, and R. A. Harkness
ADOLESCENT MEDICINE CASE STUDIES, by George D. Comerci, Elmer S. Lightner, and Ronald Hansen
PEDIATRIC BURNS, edited by Wm. Carl Bailey
A PRACTICAL GUIDE TO PAEDIATRIC INTENSIVE CARE, edited by Daniel L. Levin, Frances C. Morriss, and Gerald C. Moore
BABY SURGERY: NURSING MANAGEMENT AND CARE. 2nd edition, by Daniel G. Young and Eleanor J. Martin
PREGNANCY METABOLISM, DIABETES AND THE FETUS.