临床儿科杂志 ›› 2022, Vol. 40 ›› Issue (11): 819-823.doi: 10.12372/jcp.2022.21e1382

• 消化系统疾病专栏 • 上一篇    下一篇

86例婴儿结肠镜检查回顾性分析

沈一燚, 练敏, 李玫, 郭红梅, 张志华, 闫坤龙, 陆妍, 金玉, 刘志峰()   

  1. 南京医科大学附属儿童医院消化科(江苏南京 210008)
  • 收稿日期:2020-12-25 出版日期:2022-11-15 发布日期:2022-11-10
  • 通讯作者: 刘志峰 E-mail:liu8917@163.com
  • 基金资助:
    南京市卫健委重点项目(ZKX20042)

Retrospective analysis of the characteristics of colonoscopy in 86 infants

SHEN Yiyi, LIAN Min, LI Mei, GUO Hongmei, ZHANG Zhihua, YAN Kunlong, LU Yan, JIN Yu, LIU Zhifeng()   

  1. Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing 210008, Jiangsu, China
  • Received:2020-12-25 Online:2022-11-15 Published:2022-11-10
  • Contact: LIU Zhifeng E-mail:liu8917@163.com

摘要:

目的 了解婴儿结肠镜检查的常见病因及临床特点,并探讨结肠镜检查在婴儿中的安全性、可行性及临床价值。方法 回顾性分析2011年1月至2021年1月接受结肠镜检查的86例婴儿的临床资料。结果 男50例,女36例;中位年龄7.0(4.8~10.0)月,≤6个月33例,6~12个月53例。共实施91次无痛结肠镜检查,65例次到达回盲部(回肠末端23例次,回盲部42例次),成功率为71.4%。患儿主要临床表现为便血(41.8%)、迁延性/慢性腹泻(20.9%)及腹泻合并便血(25.6%)。≤6月组和6~12月组结肠镜检查原因差异有统计学意义(P<0.05),≤6月组迁延性/慢性腹泻比例较高。共83例(96.5%)患儿明确病因诊断,前4位病因依次为食物过敏相关消化道疾病(32/86,37.2%)、肠息肉(19/86,22.1%)、结肠/直肠炎(18/86,20.9%)及极早发型炎症性肠病(6/86,7.0%)。术后2例出现并发症,1例为术后出血,1例肠穿孔;术中未出现呼吸抑制和心跳骤停等严重并发症。结论 婴儿结肠镜下检出疾病有其特定疾病谱,结肠镜检查对慢性腹泻、便血等疾病病因有重要诊断作用。婴儿结肠镜操作风险高于较大年龄儿童,应严格掌握结肠镜检查适应证。

关键词: 结肠镜, 腹泻, 便血, 肠息肉, 炎症性肠病, 婴儿

Abstract:

Objective To investigate the common causes and clinical characteristics of infant colonoscopy, and to evaluate the safety, feasibility and clinical value of colonoscopy in infants. Methods Clinical data of 86 infants underwent colonoscopy from January 2011 to January 2021 were retrospectively analyzed. Results All infants, including 50 boys and 36 girls, with a median age of 7.0 (4.8-10.0) years, were grouped according to age, ≤6 months group (n=33 ) and 6-12 months (n=53). A total of 91 painless colonoscopies were performed, and 65 reached the ileocecal region (23 in the terminal ileum and 42 in the ileocecal region), with a success rate of 71.4%. The main clinical manifestations include hematochezia (36/86,41.8%), persistent/chronic diarrhea (18/86,20.9%), hematochezia and diarrhea (22/86,25.6%). The difference of the reason for colonoscopy examination was statistically significant between ≤6 months and 6-12 months groups (P<0.05), and the proportion of prolonged/chronic diarrhea was higher in the ≤6 months group. Of the 86 patients, 83 children received the etiological diagnosis after colonoscopy (96.4%), with food allergy-related gastrointestinal disorders (32/86, 37.2%), colonic polyps (19/86, 22.1%), colonic (rectal) inflammation (18/86, 20.9%), and VEO-IBD (6/86,7.0%). There were no serious complications such as respiratory arrest or sudden cardiac arrest during the procedure, two cases had complication after colonoscopy, one case of hemorrhage and the other of intestinal perforation. Conclusion The infant underwent colonoscopy have the different disease spectrum from older children, and colonoscopy plays an important role in the diagnosis of the chronic diarrhea and hematochezia in infant. The risk of infant colonoscopy operation is higher than that of older children, and the indications for colonoscopy should be strictly controlled.

Key words: colonoscopy, diarrhea, hematochezia, colonic polyps, inflammatory bowel disease, infant