小儿炎症性肠病23例临床分析

目的了解小儿炎症性肠病（inflammatory bowel disease，IBD）的临床、实验室检查、影像学检查和内镜检查特点，以提高对小儿炎症性肠病的诊断水平。方法对1992年3月至2007年10月复旦大学附属儿科医院消化科收治的23例炎症性肠病患儿的临床资料进行回顾性分析。结果小儿炎症性肠病以男童发病为多，腹痛、腹泻、便血为溃疡性结肠炎（ulcerative colitis，UC）与克罗思病（Crohn’s disease，CD）的共同表现，而血便以溃疡性结肠炎多见，腹痛多见于Crohn’s病，肠外表现Crohn’s病更为多见。病变部位，溃疡性结肠炎以乙状结肠分布为主，Crohn’s病以末端回肠、回盲部分布为主，与成年人炎症性肠病相比，病变累及范围更广。结论需建立统一的小儿炎症性肠病活动指标，对炎症性肠病进行系统管理，尽早做出诊断，避免小儿生长发育迟缓。

Clinical Analysis of 23 Children With Inflammatory Bowel Disease

Objective To investigate the diagnosis of inflammatory bowel disease （IBD） in children by evaluating the diversity of clinical manifestations, laboratory test, radiological and endoscopic examination. Methods Retrospective analysis of database was performed on 23 patients diagnosed as inflammatory bowel disease in the Department of Gastroenterology, Children＇s Hospital of Fudan University from March 1992 to October 2007. Results Inflammatory bowel disease was most likely to occur in boys. Abdominal pain, diarrhea and gastrointestinal bleeding were the common symptoms of ulcerative colitis （UC） and Crohn＇s disease （CD）. Gastrointestinal bleeding occurred more often in ulcerative colitis group, abdominal pain and extraintestinal manifestation more often in Crohn＇s disease group. Most lesions presented in sigmoid colon in ulcerative colitis group, while it presented in distal ileum and ileocecum in Crohn＇ s disease group. The location of lesions was more extensive compared with adults. Conclusion An uniform active index of inflammatory bowel disease should be established. Systemic management should be carried out in order to make the diagnosis on time and prevent growth failure in children.