摘要
目的分析婴幼儿慢性复杂性肛管、直肠炎症的病因及临床诊断方法。方法 2008年5月至2014年12月本院收治慢性复杂性肛管、直肠炎症患儿9例,其中男性7例,女性2例,就诊时年龄1岁8个月至3岁。结合病因诊断,回顾性分析患儿病史、辅助检查以及经验性治疗结果。结果9例患儿最终病因诊断为Cronh病7例,肠结核1例,疑诊Crohn病1例。均存在贫血及前白蛋白低下,其中有4例血清IgG增高,7例IgA增高,结核抗体均为阴性;C-ANCA弱阳性2例(Crohn病和肠结核各1例)。结肠镜显示病变累及全结肠1例,左半结肠4例,乙状结肠及直肠4例。结肠镜检查结合组织病理学表现诊断为Crohn病2例,肠结核1例,经验性药物治疗后确诊Crohn病5例,1例诊断不明。结论婴幼儿慢性复杂性肛管、直肠炎症临床诊断需要考虑非特异性炎性肠道疾病的可能性,在明确诊断并治疗原发疾病前不宜局部外科治疗。
Objetive To analyze the etiology and clinical diagnostic method for the infants chronic complex anal and rectal inflammation. Methods Nine infants with chronic complex anal and rectal inflammation were enrolled between May 2008 and Decmber 2014 at our hospital, 7 were males and 2 were females. Age ranged from/ year 8 months to 3 years. Clinical history, results of auxiliary examinations, empirical treatment of the infants, and the the etiologic diagnosis were analyzed retrospectively. Results Seven cases were diag- nosed with Cmhn＇s disease and one intestinal tuberculosis; one eases were suspected to have Crohn＇s disease. Nine cases had anemia and low pre-albumin level; four cases were found with elevated serologic IgG levels and seven cases with elevated IgA levels; seven cases were found with negative tuberculosis antibody titers and two cases with weakly positive for C-ANCA （ one case with Crohn ＂s disease and one intestinal tuberculosis）. Colonoscopies revealed that the entire colon was affected in one case, the left hemicolon was affected in four cases and the sigmoid colon and rectum were affected in four patients. Two eases with Crohn＇s disease and one case with intestinal tuberculosis were diagnosed by colonoscopies in combination with histopathologic examinations. Five cases with Crohn＇s disease were confirmed after empirical drug treatment, and one other patient were not definitely diagnosed. Conclusions The possibility of non-specific inflammatory bowel disease should be considered in the clinical diagnosis of complex chronic anal and rectal inflammation in infants. Local surgical treatment should not be performed before the final diagnosis is established and the primary disease is treated.
出处
《临床小儿外科杂志》
CAS
2016年第2期175-178,182,共5页
Journal of Clinical Pediatric Surgery
关键词
肛门疾病
直肠疾病
婴儿
Anus Diseases
Rectal Diseases
Infant
