目的 探讨儿童吞气症的临床特征、诊断和治疗。方法 回顾分析2014年1月-2018年12月诊治的35例吞 气症患儿的临床资料,并复习相关文献。结果 35例患儿中男24例、女11例,中位年龄57个月,中位病程3个月。35例患 儿均有吞气样动作及腹胀表现,其次有腹痛或腹部不适20例(57.14%)、嗳气15例(42.86%)、呕吐11例(31.43%)、稀便 10例(28.57%)、肛门排气增多9例(25.71%),其他少见表现为便秘6例(17.14%)、食欲下降5例(14.29%)、体质量下 降5例(14.29%)、头痛2例(5.71%)。19例(54.29%)患儿有可疑诱因。主要辅助检查为X线平片发现胃肠道充气明显而 无液平。给予针对诱因及病情的宣传教育,减少吞气样动作及对症处理。33例(94.29%)患儿缓解, 2例(5.71%)合并智 力发育迟缓者疗效不佳; 5例(14.29%)症状反复。结论 不同年龄儿童均可发生吞气症,且多有一定的诱因,主要表现 为弥漫性腹胀及吞气样动作, X线平片胃肠道充气明显而无液平可为其唯一特征,针对诱因的治疗效果更明显。
Objective To explore the clinical features, diagnosis and treatment of aerophagia in children. Methods The clinical data of aerophagia in 35 children diagnosed and treated from January 2014 to December 2018 were retrospective analyzed, and the relevant literature was reviewed. Results In the 35 children (24 males, 11 females) with a median age was 57 months and a median disease course was 3 months. Gas swallowing and abdominal distension were found in all cases, followed by abdominal pain or abdominal discomfort in 20 cases (57.14%), belching in 15 cases (42.86%), vomiting in 11 cases (31.43%), loose stool in 10 cases (28.57%), and increased flatus in 9 cases (25.71%). Other symptoms included constipation in 6 cases (17.14%), loss of appetite in 5 cases (14.29%), weight loss in 5 cases (14.29%), and headache in 2 cases (5.71%). And 19 children (54.29%) had the suspected triggers. The abdominal X-ray showed bowel distension without gas-fluid levels. According to the triggers and the condition, the children were educated to reduce gas swallowing and had the symptomatic treatment. The symptoms in 33 patients (94.29%) were alleviated. Two patients (5.71%) with mental retardation showed poor efficacy and 5 patients (14.29%) had recurrent symptoms. Conclusions Aerophagia can occur in children of all ages. There are a certain triggers for aerophagia. The main clinical features of aerophagia were diffuse abdominal distention and gas swallowing. The bowel distension without gas-fluid levels shown by X-ray can be the only characteristic discovery.Targeted therapy for removal of incentives is more effective in the treatment of aerophagia.