摘要
目的评价窄带成像技术（NBI）内镜在腹型过敏性紫癜（HSP）患儿临床诊断和治疗中的应用价值。方法2010年11月至2016年2月间，上海市儿童医院收治的46例腹型HSP患儿纳入观察组（均行NBI早期干预），回顾性对比分析白光及NBI内镜下腹型HSP的诊断率、靶向活检IgA阳性率和严重并发症的预判情况；从2007年至2009年间未行NBI早期干预的腹型HSP患儿资料库中电脑随机抽取25例纳入对照组，并与观察组进行对比分析。结果观察组中，NBI内镜下腹型HSP的诊断率明显高于白光内镜[91．3％（42／46）比67．4％（31／46），x^2=8．02，P〈0．05]，靶向活检IgA阳性率明显高于白光内镜[95．7％（88／92）比69．6％（64／92）x^2=21．79，P〈0．05]，并且有3例准确预判了消化道大出血等严重并发症。相比对照组，观察组的腹痛及肉眼血便消失时间[（10．96±5．32）d比（19．68±4．29）d，t=7．50，P〈0．01]、禁食时间[（10．37±5．42）d比（8．80±3．71）d，y=7．73，P〈0．01]、住院时间[（18．80±7．11）d比（23．12±4．36）d，t=3．16，P〈0．01]、大便隐血转阴时间[（11．41±6．30）d比（19．12±4．09）d，t=6．22，P〈0．01]均有明显缩短。结论对于儿童腹型HSP的诊疗，NBI内镜临床应用价值较高。NBI内镜有助于提高腹型HSP的内镜下诊断率，能精确指导活检和预判严重并发症的发生，还能对病情严重者进行早期内镜下干预，值得临床进一步研究。
Objective To evaluate value of narrow band imaging（NBI） endoscopy for children with abdominal Henoch-Schonlein purpura （HSP）. Methods A total of 46 patients with abdominal HSP were enrolled into the observation group（NBI intervention） from November 2010 to February 2016.Diagnostic rates of white light and NBI endoscopy in abdominal HSP patients, IgA positive rates of targeted biopsies and severe complications were retrospectively analyzed. A total of 25 abdominal HSP patients with no NBI intervention admitted from 2007 to 2009 were randomly enrolled into control group. Data of the control group were compared with those of observation group. Results In observation group, the diagnostic rate under NBI was significantly higher than that under white-light endoscopy [ 91.3% （42/46） VS 67. 4% （31/46） ,x^2 = 8. 02, P〈0. 05 ]. IgA positive rates of targeted biopsies under NBI was significantly higher than that under white-light endoscopy [ 95.7% （88/92） VS 69.6% （ 64/92 ）, x^2 = 21.79, P〈 0. 05 ]. Three patients developed such serious complications as digestive hemorrhage as predicted. Compared with control group, abdominal pain and blood stool relief time （ 10. 96±5.32 d VS 19. 68±4. 29 d,t=7. 50,P〈0. 01）, fasting time（ 10. 37±5. 42 d VS 8. 80± 3.71 d,t=7. 73,P〈0. 01）, hospital stay （ 18. 80±7. 11 d VS 23. 12±4. 36 d, t=3. 16,P〈0. 01）, time of stool occult blood negative （ 11.41± 6. 30 d VS 19. 12±4. 09 d, t = 6. 22, P 〈 0. 01 ） in observation group were significantly shortened. Conclusion NBI endoscopy is valuable for improving the diagnostic accuracy and biopsy accuracy and complication prediction of abdominal Henoch-Schonlein purpura in children.
出处
《中华消化内镜杂志》
CSCD
北大核心
2017年第2期88-93,共6页
Chinese Journal of Digestive Endoscopy
基金
上海市市级医院适宜技术项目（SHDC12014224）
