摘要
目的探讨超细内镜检查在新生儿过敏性直肠结肠炎诊断中的作用。方法32例最终诊断为过敏性直肠结肠炎的新生儿,采用超细内镜进行结肠镜检查。比较患儿检查前后、检查中生命体征[平均动脉压(MAP)、血氧饱和度(SpO_(2))和心率(HR)];分析内镜下表现及镜下阳性率。结果患儿检查前、检查中SpO_(2)、MAP和HR比较差异无统计学意义(P>0.05)。检查中,32例患儿肠镜进镜至回盲部20例,到达横结肠12例,其中镜下阳性31例(96.88%),主要阳性表现为黏膜充血糜烂、痘疹样隆起伴周围红斑,单纯痘疹样隆起。腹泻患儿5例,其中表现为痘疹样隆起3例,痘疹样隆起伴红斑1例,镜下表现正常1例,镜下阳性率为80.00%(4/5);腹胀患儿1例,镜下表现为痘疹样隆起,镜下阳性率为100.00%(1/1);便血患儿26例,其中表现为痘疹样隆起伴红斑6例,充血糜烂20例,镜下阳性率为100.00%(26/26)。3种镜下表现黏膜活检病理检查,均提示为黏膜慢性炎,有不同程度嗜酸粒细胞浸润。在检查中,32例患儿无腹胀、呼吸暂停等不良事件发生。结论超细内镜在新生儿过敏性直肠结肠炎中应用具有较高的诊断价值及安全性,对于该疾病的早期诊治具有指导意义。
Objective To discuss the role of ultrathin endoscopy in neonatal allergic proctocolitis.Methods 32 neonates diagnosed with allergic proctocolitis underwent colonoscopy by ultrathin endoscopy.The vital signs[mean arterial pressure(MAP),oxygen saturation(SpO_(2))and heart rate(HR)]were compared before and during the examination.The endoscopic manifestations and positive rate were analyzed.Results The differences in SpO_(2),MAP and HR before and during the examination were not statistically significant(P>0.05).During the examination,the enteroscopy reached the ileocecal region in 20 cases and the transverse colon in 12 cases,of which 31 cases(96.88%)were endoscopically positive,with the main positive manifestations being mucosal congestion and erosion,poxiform augmentation with surrounding erythema,and simple poxiform augmentation.There were 5 children with diarrhea,including 3 children with pimple-like elevation,1 child with pimple-like elevation with erythema,and 1 child with normal endoscopic appearance,with a positive endoscopic rate of 80.00%(4/5);1 child with abdominal distention,with pimple rash-like elevation,with an endoscopic positive rate of 100.00%(1/1);26 children with blood in stool,including 6 children with pimple rash-like elevation with erythema and 20 children with congested vesicles,with an endoscopic positive rate of 100.00%(1/1);and 26 children with blood in stool,including 6 children with pimple rash-like elevation with erythema and 20 children with congestion and erosion,with an endoscopic positive rate of 100.00%(26/26).All three endoscopic manifestations of mucosal biopsy pathology suggested chronic inflammation of the mucosa with varying degrees of eosinophilic infiltration.During the examination,no adverse events such as abdominal distension and apnea occurred in 32 children.Conclusion The application of ultra-fine endoscopy in neonatal allergic rectal colitis has high diagnostic value and safety,and has guiding significance for the early diagnosis and treatment of this disease.
作者
王宝林
蒋成鹏
陈颢予
连娇燕
徐晓红
WANG Bao-lin;JIANG Cheng-peng;CHEN Hao-yu(Department of Pediatric Gastroenterology,Maternal and Child Health Care Hospital of Gansu Province,Lanzhou 730050,China)
出处
《中国现代药物应用》
2023年第14期59-62,共4页
Chinese Journal of Modern Drug Application
基金
甘肃省科技计划项目(项目编号:20JR5RA136)。
