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目的 研究儿童消化性溃疡伴出血的发生率、临床特点及出血导致的危重症表现 ,了解其病理改变及与幽门螺杆菌 (H·pylori)感染的关系。方法 比较出血组与未出血组患儿临床特点、胃镜发现、H·pylori检测结果及病理组织学检查 ,并对出血性溃疡组患儿伴发的危重症进行评估。结果 15 2例消化性溃疡患儿中 88例伴有出血 ,占总数的 5 7 9%。出血组中男性 6 9例 ,占出血组的 78 4 % ,与非出血组比较 ,差异有显著性 (P <0 0 5 )。在出血组患儿中 ,病程不超过 1周者 2 7例 (30 7% ) ,非出血组 6例 (9 4 % ) ,差异有显著性 (P <0 0 5 )。胃窦部单发溃疡和胃多发溃疡在出血组与非出血组间差异有显著性。出血组中表现血容量不足者 5 5例(6 3 2 2 % ) ,失血性休克 19例 (2 1 84 % ) ,严重贫血 (中～重度贫血 ) 5 8例 (6 6 6 7% )。H· pylori检测阳性率出血组为 39 0 8% ,未出血组为 6 2 5 % ,P <0 0 0 1。病理组织学检查结果两组差异无显著性。结论 儿童时期消化性溃疡并发出血的发生率高 ,且出血量大 ,可导致明显的血容量不足 ,甚至出现失血性休克表现及中～重度贫血。
Objective To study the incidence of peptic ulcer with hemorrhage in children, clinical features and bleeding-induced critical illness performance, to understand the pathological changes and Helicobacter pylori (H · pylori) infection. Methods The clinical features, gastroscopy findings, H. pylori test results and histopathological examination in children with hemorrhagic or non-hemorrhagic bleeding were compared, and the critical illness associated with hemorrhagic ulcer patients was evaluated. Results Fifty-two children with peptic ulcer had hemorrhage, accounting for 57.9% of the total. There were 69 males in the bleeding group, accounting for 78.4% of the bleeding group, there was a significant difference between the two groups (P <0.05). In the bleeding group, there were 27 cases (30.7%) with no more than one week course and 6 cases (9.4%) with no bleeding group, the difference was significant (P <0.05). Single gastric ulcer and gastric ulceration in the bleeding group and non-bleeding group differences were significant. Fifty-five (63.2%) patients showed hemorrhagic hypovolemia, 19 (2184%) had hemorrhagic shock, and 58 (66.67%) had severe anemia (moderate-severe anemia). The positive rate of H. pylori detection was 39 0 8% in the bleeding group and 62 5% in the non-bleeding group, P <0.01 1. Histopathological examination results showed no significant difference between the two groups. Conclusion The incidence of peptic ulcer complicated by hemorrhage in childhood is high, and the amount of hemorrhage is large. It can lead to obvious hypovolemia and even hemorrhagic shock and moderate to severe anemia.