107例小儿消化道出血胃镜检查结果分析

目的：了解不同年龄组消化道出血的病因和合理的胃镜检查时间。方法：对107例临床疑似上消化道出血的患儿进行纤维胃镜检查。结果：确诊为上消化道出血的79例（十二指肠溃疡61例，胃溃疡7例，食道静脉曲张3例，食管炎1例，贲门粘膜撕裂症3例，十二指肠憩室2例，脑疝2例），小肠出血6例（3例小肠憩室、2例克隆氏病，1例小肠结核） ，咽血综合症3例，未检查出病因19例。结论：十二指肠球部溃疡、胃溃疡是年龄较大儿童消化道出血最常见的原因，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，患儿在出血48h内纤维胃镜检查阳性率最高，小儿上消化道出血急症胃镜检查是一种快速、准确、较安全的检查方法。

Gastrointestinal Endoscopy for 107 Children with Gastrointestinal Hemorrhage

Objective:To investigate the pathogeny of children with gastrointestinal hemorrhage and the right check-up time of gastrointestinal endoscopy.Methods:Check up 107 children with suspected upper gastrointestinal hemorrhage (UGH) by gastrointestinal endoscopy.Results:79 cases of UGH were diagnosed,including duodenal ulcer (61 cases),gastric ulcer (7 cases),esophageal varices (3 cases),esophagitis (1 case),cardia tear (3 cases),duodenal diverticulum (2 cases) and diaphragmatocele (2 cases);6 case of small intestine bleeding (including 3 cases of small intestine diverticulum,2 cases of Crohnn's disease and 1 case of enteric tuberculosis) and 3 cases of gulping blood syndrome were also diagnosed;the pathogeny of 19 cases were not clear.Conclusion:Gastric ulcer and duodenal bulb ulcer are the most common cause of gastrointestinal hemorrhage of elder children and inherited alimentary canal abnormality leads to gastrointestinal hemorrhage of infants.The positive reaches the highest level when the endoscopy examination is carried on within 48 hours after the lastest bleeding.