Quak S H, Lam S K, Low P S
Department of Paediatrics, National University Hospital, Singapore.
Singapore Med J. 1990 Apr;31(2):123-6.
The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.
本文旨在研究儿童上消化道（GI）纤维内镜检查的应用。对连续转诊至作者之一处的200例患者进行了回顾性研究。这200例患者进行上消化道内镜检查的适应证为：（1）反复腹痛（46.5%），（2）持续性呕吐（14.5%），（3）呕血（14.5%），（4）急性腹痛（13%），以及（5）其他适应证，如异物取出、生长发育不良和不明原因胸痛（11.5%）。内镜检查使用奥林巴斯P3或奥林巴斯XP - 10型胃镜。所用镇静方法为静脉注射哌替啶（2mg/kg）和地西泮（0.5mg/kg）联合使用。在反复腹痛的患者中，上消化道内镜检查显示7例（7.5%）十二指肠溃疡，4例（4.3%）十二指肠炎，4例（4.3%）食管炎，2例（2.2%）胃溃疡。其余患者正常（81.7%）。对于持续性呕吐，37.9%的患者显示胃食管反流，6.9%有食管裂孔疝。在29例因上消化道出血接受内镜检查的患者中，27.6%未发现出血病灶。其余72.4%的出血原因分别为急性胃黏膜糜烂（27.6%）、食管炎（17.2%）、食管静脉曲张（13.8%）、十二指肠溃疡（10.3%）和马-魏综合征（3.5%）。大多数急性腹痛患者内镜检查正常（61.5%）。两个常见的异常发现是急性胃炎（27.0%）和急性十二指肠炎（11.5%）。在这200例患者的检查过程中未遇到重大并发症。得出的结论是，上消化道内镜检查有助于明确上消化道黏膜病变。该检查在镇静下可安全地在儿童中进行。
