136例小儿消化道出血临床分析

目的 :了解不同年龄组消化道出血病因分布及纤维胃镜诊断前误诊的原因。方法 :对 1 3 6例临床疑为上消化道出血的患儿进行纤维胃镜检查 ,个别病例经剖腹探查诊断。结果 :确诊为上消化道出血者 1 0 3例、小肠出血7例、咽血综合症 4例、未检查出病因 2 2例。结论 :十二指肠溃疡、胃溃疡是年龄较大儿童消化道出血最常见的原因 ;在消化道出血前 ,部分患儿因腹痛误诊为“蛔虫病”或“肠痉挛”。先天性消化道畸形是婴幼儿消化道出血的另一个重要原因 ,患儿应在出血 48h内做纤维胃镜检查以获最高的阳性率。

Analysis of 136 children with gastrointestinal hemorrhage

Objective To investigate the pathogeny of children with gastrointestinal hemorrhage, pathogeny distribution and the cause of misdiagnosis before gastrointestinal endoscopy check-up. Methods We detected 136 children suspected upper gastrointestinal hemorrhage (UGH) by gastrointestinal endoscopy and among them a few cases were diagnosed by celiotomy. Results One hundred and three cases of UGH, 7 cases of small intestine bleeding, and 4 cases of gulping blood syndrome were diagnosed; but the pathogeny of the other 22 cases was not clear. Conclusion Gastric ulcer and duodenal ulcer are the common causes of gastrointestinal hemorrhage of elder children and inheriting alimentary canal abnormality leads to gastrointestinal hemorrhage of infants. Some children with bellyache were misdiagnosed as ascariasis or enterospasm. The endoscopy examination should carry on within 48 hours after the latest bleeding to reach the highest positive rate.