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中国循证儿科杂志

中国循证儿科杂志 ›› 2017, Vol. 12 ›› Issue (3): 170-174.

• 论著 • 上一篇    下一篇

基于横断面调查的儿童胃镜检查适应证及其与胃显著病变的相关性分析

王胜楠1），陆晓岚1），陈莲2），黄瑛1）   

  1. 复旦大学附属儿科医院 上海，201102；1）消化科，2）病理科
  • 收稿日期:2017-06-25 修回日期:2017-06-25 出版日期:2017-06-25 发布日期:2017-06-25
  • 通讯作者: 黄瑛

A cross-sectional study of indications of esophageal gastroduodenoscopy in children and the correlation analysis of indications and significant findings

WANG Sheng-nan1), LU Xiao-lan1), CHEN Lian2), HUANG Ying1)   

  1. Children's Hospital of Fudan University, Shanghai 201102, China; 1) Gastroenterology Department, 2) Pathology Department
  • Received:2017-06-25 Revised:2017-06-25 Online:2017-06-25 Published:2017-06-25
  • Contact: HUANG Ying

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1095

被引次数

4

摘要：

目的：行胃镜适应证的调查，分析消化道症状、体征和病史与胃显著病变的相关性。方法：采用横断面研究设计调查行胃镜检查时消化道症状、体征和病史，自拟胃镜检查适应证调查表（简称调查表）；对调查表项目（消化道症状、体征和病史）先行单因素分析，再行多因素分析。胃显著病变：胃镜检查黏膜隆起增生、解剖学异常、胃内发现胆汁返流、快速尿素酶染色阳性和消化道异物报告，和/或胃黏膜病理诊断炎症中至重级。结果：2016年6月10日至2016年10月7日符合本文纳入和排除标准的儿童行胃镜检查并取得调查表1 298份，男766例，年龄0.1~17.6（8.0±0.1）岁，仅以主诉中第一个症状或体征或病史统计，行胃镜检查的患儿中，腹痛占78.0%，其次是纳差31.3%、口气24.9%、幽门螺旋杆菌感染18.0%、恶心17.0%、呕吐16.7%、主要抚养人Hp感染史13.4%，余症状、体征和病史均低于10%。胃显著病变率49.9%（648/1 298），幽门螺旋杆菌感染证据、呕吐和可疑消化道异物与胃显著病变呈正相关，OR分别为5.10（95%CI：3.58~7.28）、1.48（95%CI：1.07~2.03）和3.25（95%CI：1.31~8.02），腹痛、反酸与胃显著病变呈负相关，OR为0.73（95%CI：0.54~0.98）、0.25（95%CI：0.09~0.70）。鉴于78.0%患儿以腹痛为主诉行胃镜检查，以调查表的腹痛时间均值（≥7个月）、腹痛频率均值（≥11天/月）、腹痛程度均值（≥5分，Wong-Banker面部表情评分法）为自变量，以胃镜发现显著病变作为因变量，多因素回归分析显示，腹痛程度≥5分与胃显著病变正相关，OR为1.37（95%CI：1.07~1.74）。结论：行胃镜检查的患儿78.0%以腹痛为主诉，幽门螺旋杆菌感染证据、呕吐和可疑消化道异物患儿与胃显著病变呈正相关，腹痛程度≥5分与胃显著病变正相关。

关键词: 儿童, 适应证, 胃镜

Abstract:

Objective: An investigation about esophageal gastroduodenoscopy (EGD) was performed, and the association between the symptoms or history and significant findings was analyzed.Methods: This cross-sectional study was conducted through a questionnaire formulated by ourselves. Then we chi-square statistical test and multivariate Logistical regression were used to analyze the correlation between indications and significant findings. Results: The study was conducted from June 10, 2016 to October 7, 2016. And 1 298 cases (male 766) were enrolled. The age was from 0.1 to 17.6 (average age: 8.0±0.01) years. Patients with abdominal pain accounted for 78.0%, then anorexia 31.3%, having breath 24.9%, having evidence for Helicobacter pylori infection 18%, nausea 17%, vomiting 16.7%, having a family history of Helicobacter pylori infection 13.4%. Others were all below 10%. There were 49.9 % having a significant lesion through EGD. Evidence of infection of helicobacter pylori (OR=5.10, 95% CI: 3.58 ~7.28), vomiting (OR=1.48, 95% CI: 1.08~2.04)and suspicious foreign body injection 3.25（95%CI: 1.31~8.02）were related with significant findings. While abdominal pain was related with significant findings (OR=0.73, 95% CI: 0.54~0.98), further investigation was made for abdominal pain. And it was found that the degree value of abdominal pain beyond 5 was related with significant findings (OR=1.37, 95% CI: 1.07~1.74). Conclusion78% of EGD patients are with the complain of abdominal pain. Evidence of infection of helicobacter pylori, vomiting and suspicious foreign body injection are positively related with significant findings. And the degree value of abdominal pain beyond 5 is positively related with significant findings.

Key words: Children, Esophageal gastroduodenoscopy;Indications