功能性便秘患儿胃肠传输时间的测定

背景:功能性便秘对小儿的身心健康、社会心理发育和远期生活质量均有很大影响.目前国内尚无儿童功能性便秘的确切定义,无明确分型,亦无统一诊断标准和系统的治疗方案.而胃肠传输时间测定是客观了解胃肠转运功能的动力学检查方法之一,对胃肠道动力异常的诊断、病因研究和疗效评价具有重要意义,是目前诊断慢传输型便秘的惟一无创手段.目的:分析功能性便秘患儿和正常儿童胃肠传输时间区别,了解胃肠传输时间测定在评估全胃肠及各段动力的意义.设计:以患儿、正常儿童为研究对象,病例-对照,观察对比研究.单位:武警部队广东总队医院儿科.对象:研究对象为2002-08广州市某幼儿园和某小学健康儿童共68例及2002-03/2003-01在武警部队广东总队医院儿科门诊确诊或住院的功能性便秘患儿28例. 方法:通过口服不透X线标志物,用X线拍片法分别于12,24和48 h摄腹部平片,测定28例功能性便秘患儿和68例正常儿童全胃肠传输时间、口-盲时间和结肠传输时间.主要观察指标:功能性便秘患儿与正常儿童全胃肠传输时间、口-盲时间、结肠传输时间以及右半结肠传输时间、左半结肠传输时间、直肠乙状结肠传输时间比较.结果:正常儿童及功能性便秘患儿的50%全胃肠传输时间[(23.6±1.6),(80.4±2.1)h],口-盲时间[(9.9±1.4),(20.7±0.6)h]和结肠传输时间[(14.8±0.8),(59.9±2.3)h]比较,差异有显著性意义(P<0.01).两组儿童右半结肠传输时间、左半结肠传输时间和直肠乙状结肠传输时间比较,差异也有显著性意义(P<0.01).结论:正常儿童胃肠传输时间明显不同于功能性便秘患儿;胃肠传输时间测定可了解全胃肠及各段的动力情况,对功能性便秘的诊断及评估治疗效果有实用意义.

Determination of gastrointestinal transit time in functional constipation in children

BACKGROUND: Functional constipation (FC) might exert great influence on children in body and mental health, social-psychological development and long-term life quality. At present, there is not precise definition, clear classification, unite diagnostic standards and practicable systematic treatment project for FC in children. As a non-traumatic diagnostic means for chronic transiting constipation, gastrointestinal transit time (GTT) is considered as one of the objective indexes for dynamically observing gastrointestinal transit function, and has significance in the diagnosis of abnormal gastrointestinal dynamics, etiological investigation and therapeutic effect assessment.OBJECTIVE: To investigate the difference of GTT between constipation children and normal healthy control, so as to elicit its significance in assessing the dynamics of whole gastro-intestine and each segment.DESIGN: Case control comparative study based on FC children and healthy children.SETTING: Department of Pediatrics, Guangdong Provincial General Hospital, Chinese People's Armed Police Forces.PARTICIPANTS: This study was carried out at Pediatric Department of Guangdong Provincial General Hospital, Chinese People' s Armed Police Forces. Totally 28 children with confirmed FC in the General Hospital of Armed Police took part in the experiment, and 68 healthy children from a certain kindergarten and an elementary school in Guangdong province were selected as normal controls.METHODS: Whole gastrointestinal transit time(GTT), mouth-intestine transit time and colon transit time(CTT) were determined with plain abdominal photograph at 12 hours, 24 hours and 48 hours after orally administrated of radio-opaque markers.MAIN OUTCOME MEASURES: Whole GTT, mouth-intestine transit time and CTT, as well as right colonic transit time, left colonic transit time, rectosigmoid transit time.RESULTS: 50% whole gastrointestinal transit time, mouth-intestine transit time and CTT were[(23.6±1.6) vs (80.4±2.1) hours], [(9.9±1.4)vs(20.7±0.6) hours] and[(14.8±0.8) vs (59.9±2.3) hours] in constipation and healthy group respectively, with significant difference between them( P < 0.01 ) . Moreover there was statistical difference in right colon transit time, left colon transit time and rectosiqmoid transit time between two groups( P < 0.01).CONCLUSION: GTT of constipation children is obviously different from that of healthy children; it can be used for assessing the dynamics of whole gastrointestine and each segment, thereby possess practical significance in the diagnosis and therapeutic effect assessment of FC in children.Yang M, Wang BX, Wang MG. Determination of gastrointestinal transit time in functional constipation in children.