论文部分内容阅读
目的探讨小儿幽门管溃疡的临床特点,提高其诊断及治疗水平。方法回顾分析2001年2月至2008年2月湖南省儿童医院收治的36例幽门管溃疡患儿的临床表现,胃镜、钡餐检查的特点及其治疗和预后。结果36例中以呕吐为首发表现的患儿有33例,占91.6%,可伴食欲减退、腹痛、排黑便、面色苍黄、消瘦、腹部包块,合并不同程度的贫血、体内代谢紊乱(代谢性碱中毒,低钠、低钾、低氯血症),胃镜和钡餐检查可见幽门管溃疡并幽门梗阻。结论小儿幽门管溃疡的首发表现为呕吐,胃镜和钡餐检查是确诊幽门管溃疡的主要手段。治疗以抑酸、禁食、胃肠减压(3～5d)等内科保守治疗为主;对少数难以控制的大出血、幽门完全性梗阻经保守治疗72h无效者及易复发的多发性幽门管溃疡者宜手术治疗。
Objective To investigate the clinical features of pediatric pyloric ulcer and to improve its diagnosis and treatment. Methods The clinical manifestations, gastroscopy and barium meal examination of 36 children with pyloric ulcer admitted to Children’s Hospital of Hunan Province from February 2001 to February 2008 were retrospectively analyzed. The characteristics, treatment and prognosis of gastroscopy and barium meal were retrospectively analyzed. Results Thirty-three (91.6%) of the 36 patients showed vomiting as the first manifestation, with anorexia, abdominal pain, melena, pale yellow, emaciation, abdominal mass with varying degrees of anemia and metabolic disorders Metabolic alkalosis, hyponatremia, hypokalemia, hyponatremia), gastroscopy and barium meal examination revealed pyloric ulcer and pyloric obstruction. Conclusion The first manifestation of pediatric pyloric ulcer is vomiting. Gastroscopy and barium meal examination are the main means of diagnosing pyloric ulcer. Treatment with acid suppression, fasting, gastrointestinal decompression (3 ~ 5d) and other medical conservative treatment; a few difficult to control the bleeding, pyloric complete obstruction after conservative treatment of 72h ineffective and easy to relapse of multiple pyloric ulcer Should be surgical treatment.