儿童溃疡性结肠炎172例

目的分析中国儿童溃疡性结肠炎（UC）患者的临床资料为其诊治提供帮助。方法采用CBM、CNKI及VIP数据库检索1995~2004年国内发表的儿童UC的文献,对符合纳入标准者及同期本院确诊UC患儿172例的临床特征、X线和内镜表现、组织学特点、治疗及预后进行分析。结果172例中男女之比是1.07：1.0;就诊年龄2个月~15岁,≤3岁36.7%;病程3d~4年;阳性家族史1例。儿童UC以慢性腹泻、黏液血便或脓血便、腹痛为主要表现,发热、体质量减低或营养不良、贫血等全身表现常见,肠外表现及并发症少见,病变范围以全结肠为主,病情以中重型居多。以水杨酸偶氮磺胺吡啶（SASP）或5-乙酰水杨酸（5-ASA）为基础,配合糖皮质激素治疗在短期内可获得临床缓解,但长时程随访完全缓解者不足1/3。结论婴幼儿UC患者并不少见,儿童UC临床特征有异于成人,3岁前后亦不尽相同。儿童UC误诊率高,治疗困难。制定一套适合中国儿童UC的诊疗规范十分必要。

One Hundred and Seventy-Two Cases with Ulcerative Colitis in Children

Objective To investigate the diagnostic and therapeutic experience in children with ulcerative colitis(UC) from clinical data.Met-hods The literature on UC in children publicated from 1995 to 2004 were retrieved by CBM,CNKI and VIP database.The clinical manifestations,X-ray,endoscopic and histologic features,management and prognosis of 172 patients in this hospital correspond with the inclusion criteria were retrospectively investigated and a definite diagnosis with UC was made.Results Of 172 patients,the ratio of maleold female was 1.07:1.0,and the age of patients ranged from 2 months to 15 years old.Thirty-six patients(36.7%)were less than 3 years-old;the course ranged from 3 days to 4 years.One patient had family history.The main manifestations were chronic diarrhea,mucus bloody stool,bloody purulent stool and abdominal pain.The systemic symptoms were fever,weight loss,malnutrition and anemia,no enteral symptoms and complications.The lesions were mainly seen in the whole colon with moderate to severe degree.The therapies based on salicylaxosulfapyridine(SASP) or 5-acetylsalicylic acid(5-ASA) together with corticosteroid in the short period have clinical remission in different levels.From long follow-up,the complete remittence was less than one third.Conclusions It is not rare to see UC in infantile.The clinical characteristics of UC in children are different from those in adults,the same is true before and after 3 year-old.The UC in children has high misdiagnosis and is difficult to manage.It is very necessary to establish a diagnostic and therapeutic guideline for children with UC in China.