摘要
目的探讨小儿再发性腹痛伴肠系膜淋巴结肿大与幽门螺杆菌(Hp)感染等的关系,观察Hp感染的再发性腹痛伴肠系膜淋巴结肿大儿童根除Hp治疗的临床情况。方法 79例再发性腹痛伴肠系膜淋巴结肿大行胃镜检查及Hp根除的患儿为研究对象,分析胃镜检查、肠系膜淋巴结超声和Hp检测结果 ,计算患儿治疗后Hp根除率,对比治疗前后患儿的肠系膜肿大淋巴结平均最大长、短径,观察治疗效果。结果 79例患儿中胃镜下诊断患有胃黏膜病变72例,占91.1%,包括慢性浅表性胃炎69例,其中伴十二直肠球炎16例、伴食管炎6例、伴胆汁返流12例;胃溃疡1例;十二指肠球部溃疡2例。所有患儿超声检查腹腔均可发现3个及以上淋巴结,在脐周部发现74例,回盲部和脐周部均发现5例。本组患儿Hp感染阳性率为96.2%(76/79),76例Hp感染患儿均完成随访治疗研究。在完成随访治疗的76例患儿中,治疗有效72例,治疗无效4例。Hp感染患儿治疗后肠系膜肿大淋巴结平均最大长径为(7.10±1.50)mm,明显小于治疗前的(13.10±2.90)mm,差异具有统计学意义(t=16.02,P=0.00<0.05);治疗后肠系膜肿大淋巴结平均最大短径为(3.00±0.60)mm,明显小于治疗前的(5.75±1.10)mm,差异具有统计学意义(t=19.13,P=0.00<0.05)。Hp感染患儿中有67例Hp根除,根除率为88.2%。结论 Hp感染及胃黏膜病变与小儿再发性腹痛伴肠系膜淋巴结肿大有关,根除Hp可显著减轻Hp感染的再发性腹痛伴肠系膜淋巴结肿大患儿的病情。
Objective To investigate the correlation between recurrent abdominal pain complicated by mesenteric lymphadenopathy and Helicobacter pylori（Hp） infection in children, and observe the clinical condition of children with recurrent abdominal pain complicated with mesenteric lymphadenopathy and Hp infection treated with Hp eradication. Methods A total of 79 children with recurrent abdominal pain accompanied by mesenteric lymphadenopathy all received gastroscopy examination and Hp eradication. The results of gastroscopy, mesenteric lymph node ultrasonography and Hp examination were analyzed, and the Hp eradication rate was calculated. The average length and the shortest diameter of mesenteric lymph nodes were compared before and after treatment, and the therapeutic effects were observed. Results In 79 children, endoscopic diagnosis showed that there were 72 gastric mucosal lesions, accounting for 91.1%, including 69 chronic superficial gastritis cases, in which 16 cases complicated with duodenal inflammation, 6 cases with esophagitis, 12 cases with bile reflux, 1 gastric ulcer, and 2 intestinal ulcer cases. In all the children, 3 or more lymph nodes were found in the abdominal cavity by ultrasonography. 74 cases were found at the umbilicus, and 5 cases were found in the ileocecal region and the umbilicus. The positive rate of Hp infection in this group was 96.2%（76/79）, and 76 children with Hp infection were followed up for treatment. In 76 children with completed follow-up treatment, there were 72 effective cases and 4 ineffective cases. After treatment, Hp infection children had obviously shorter mean maximum diameter of mesenteric lymph nodes as（7.10±1.50） mm than（13.10±2.90） mm before treatment, and the difference was statistically significant（t=16.02, P=0.000.05）. After treatment, children had obviously shorter mean minimum diameter of mesenteric lymph nodes than（5.75±1.10） mm before treatment, and the difference was statistically significant（t=19.13, P=0.000.05）. There were 67 Hp e
出处
《中国实用医药》
2017年第32期21-23,共3页
China Practical Medicine
关键词
幽门螺杆菌
腹痛
肠系膜淋巴结
胃炎
儿童
Helicobacter pylori
Abdominal pain
Mesenteric lymphadenopathy
Gastritis
Children
