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中国汉族人群婴儿肥厚性幽门狭窄的临床特征:1998 年至 2010 年的分析。

The clinical features of infantile hypertrophic pyloric stenosis in Chinese Han population: analysis from 1998 to 2010.

机构信息

Department of Gastroenterology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China ; Guangzhou Key Laboratory of Digestive Disease, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.

Department of Pediatrics, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

PLoS One. 2014 Feb 19;9(2):e88925. doi: 10.1371/journal.pone.0088925. eCollection 2014.

Abstract

OBJECTIVE

To investigate clinical features of infantile hypertrophic pyloric stenosis (IHPS) in Chinese Han population.

METHODS

Three hundred and sixteen hospitalized patients with IHPS from January 1998 to February 2010 were retrospectively reviewed, and data including patient's sex, onset age, other coexisting congenital defects, pyloric circular muscle thickness evaluated by ultrasonograph, serum electrolytes concentration, and results of arterial blood gas analysis on admission were collected. The patients were divided into two groups: the duration between first onset and admission less than or equal to 10 days (early onset group), and more than 10 days (late onset group). The results of arterial blood gas and serum electrolyte concentration were compared between the two groups.

RESULTS

There were 271 males and 45 females in 316 patients; the onset age ranged between 1 and 351 (26.5±26.6) days. The birth weight ranged between 1.6 and 4.5 (3.23±0.44) kilograms; coexisting congenital defects were found in 65 cases (20.6%). Pyloric circular muscle thickness was 4-8 (5.4±1.0) millimetres (mm). For the early onset group, the rates of hypokalemia, hypochloraemia and hypercapnia were significantly lower than those in the late onset group (18.67% VS 50%, P<0.0001; 46.03% VS 71.01%, P = 0.003; 56.58% VS 83.44%, P = 2.17×10(-5); respectively).

CONCLUSIONS

The symptom duration in Chinese Han population was longer than that in other populations. And as the prolongation of symptom duration, the incidence of acid-base imbalance increased significantly. Infants with persistent vomiting at the age of 3∼5 weeks after birth should be considered IHPS, and go to hospital as soon as possible in order to reduce the incidence of hypokalemia, hypochloraemia and hypercapnia, and avoid deterioration.

摘要

目的

探讨汉族婴儿肥厚性幽门狭窄(IHPS)的临床特征。

方法

回顾性分析 1998 年 1 月至 2010 年 2 月收治的 316 例 IHPS 住院患儿的临床资料,包括患儿的性别、发病年龄、其他并存的先天性畸形、超声检查幽门环肌厚度、入院时血清电解质浓度和动脉血气分析结果。根据患儿发病至入院时间将其分为两组:发病至入院时间≤10 d 为早发型组,>10 d 为晚发型组。比较两组患儿动脉血气和血清电解质浓度的结果。

结果

316 例患儿中男 271 例,女 45 例;发病年龄 1~351(26.5±26.6)d。出生体质量 1.6~4.5(3.23±0.44)kg;并存先天性畸形 65 例(20.6%)。幽门环肌厚度 4~8(5.4±1.0)mm。早发型组低钾血症、低氯血症和高碳酸血症的发生率明显低于晚发型组(18.67%比 50%,P<0.0001;46.03%比 71.01%,P=0.003;56.58%比 83.44%,P=2.17×10(-5))。

结论

汉族 IHPS 患儿的症状持续时间长于其他人群,随着症状持续时间的延长,酸碱失衡的发生率显著增加。对于出生后 3~5 周出现持续呕吐的婴儿,应考虑 IHPS,并尽快就医,以减少低钾血症、低氯血症和高碳酸血症的发生,避免病情恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ffd/3929628/ae8ddb89b2f4/pone.0088925.g001.jpg

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