摘要
目的总结小儿消化道出血的诊治经验，探讨小儿不明原因消化道出血的诊治流程。方法回顾性分析2011年1月至2013年12月收治不明原因消化道出血患儿114例的临床资料。其中，按常规流程（常规组）诊治73例，胃、肠镜与腹腔镜联合（联合组）诊治41例。结果小儿不明原因消化道出血常见疾病包括：梅克尔憩室、十二指肠球部溃疡、肠重复畸形、血管瘤、小肠息肉及过敏性紫癜。小儿不明原因消化道出血治疗中，常规组输血率为31．5％（23／73）明显高于联合组17．1％（7／41），二者比较差异有统计学意义（X^2=4．39，P〈0．05）；联合组较之常规组确诊时间（Z=3．63，P〈0．05）及住院时间（Z=4．95，P〈0．05）明显缩短。结论胃、肠镜与腹腔镜联合诊治可以放宽不明原因消化道出血的手术探查指征。胃、肠镜与腹腔镜联合“一站式”杂交手术诊治小儿消化道大出血，可以明显缩短救治时间，提高诊疗效果。
Objective To summarize the experiences in the diagnosis and treatment of pediatric gastrointestinal bleeding and evaluate its management guideline. Methods From January 2011 to December 2013, 114 cases of obscure gastrointestinal bleeding were reviewed. The routine group （n = 73） was treated conventionally while the combined group （n = 41） underwent laparoscopy plus gastrocolonoscopy. Results The causes included Meckel＇s diverticulum, duodenal ulcer, intestinal duplication, hemangioma, intestinal polyps and allergic purpura. The blood transfusion rate in the routine group was significantly higher than that of the combined group [31.5% （23/73） vs. 17. 1% （7/41）,）（2 = 4. 39, P〈0. 05]. In the combined group, the diagnostic time （Z= 3. 63, P〈0. 05） and hospital stay （Z= 4. 95, P〈0. 05） significantly decreased than the routine group. Conclusions The indications of gastric endoscopy plus laparoscopy in the diagnosis and treatment of massive gastrointestinal bleeding may be relaxed. The protocol of ＂ one-stop hybrid operation＂ （gastrocolonoscopy plus laparoscope） in the diagnosis and treatment of massive hemorrhage of digestive tract can significantly shorten the treatment course and improve the efficacies.
出处
《中华小儿外科杂志》
CSCD
北大核心
2014年第6期419-423,共5页
Chinese Journal of Pediatric Surgery
关键词
胃肠出血
胃肠镜
腹腔镜
Gastrointestinal bleeding
Gastrointestinal endoscopy
Laparoscopy
