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目的:探讨儿童克罗恩病(Crohn′s,CD)的临床特点及诊断和治疗,以提高儿童CD的诊断、治疗水平,减少急重型病例的误漏诊。方法:回顾我院2007年经内镜、手术和病理证实的2例儿童重症CD,并结合近期文献进行分析。结果:2例儿童重症CD均并发肠道多发穿孔,行外科病变肠段切除。并经儿内科治疗后缓解出院,目前仍在随访。结论:儿童CD早期诊断极为困难,易误漏诊。内镜加组织学是诊断CD的金标准,胃肠道直接显影对于明确儿童肠道炎症的部位、范围和类型极为重要。除皮质类固醇、氨基水杨酸类药物治疗外,可选用免疫调节制剂治疗。肠穿孔是炎症性肠病最主要的并发症和儿童CD主要的死亡原因。
Objective: To investigate the clinical features, diagnosis and treatment of Crohn’s disease (CD) in children so as to improve the diagnosis and treatment of CD in children and reduce the misdiagnosis of acute and severe cases. Methods: Two children with severe CD confirmed by endoscopy, surgery and pathology in our hospital in 2007 were retrospectively analyzed, combined with the recent literatures. Results: Two cases of children with severe CD were complicated by intestinal perforation, surgical removal of bowel segment. And relieved by the medical treatment after discharge, is still under follow-up. Conclusion: Early diagnosis of CD in children is extremely difficult and missed diagnosis. Endoscopic and histological diagnosis of CD is the gold standard, direct gastrointestinal development of clear intestinal inflammation in children of the site, the scope and type is extremely important. In addition to corticosteroids, amino acid salicylic acid treatment, the choice of immunomodulatory agents. Bowel perforation is the most important complication of inflammatory bowel disease and the leading cause of death in children’s CDs.