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[小儿胃肠病学:研究的起源、问题与前景]

[PEDIATRIC GASTROENTEROLOGY: ORIGINS, PROBLEMS, AND PROSPECTS OF THE RESEARCH].

作者信息

Zaprudnov A M, Kharitonova L A, Grigoriev K I, Bogomaz L V

出版信息

Eksp Klin Gastroenterol. 2015(1):4-12.

Abstract

The nomenclature of digestive diseases in children was supplemented by the "new" diseases: of esophagus--gastroesophageal reflux disease (GERD), Barrett's esophagus, Zenker's diverticulum; of stomach and duodenum--gastroduodenitis, peptic ulcer disease, polyps, ectopic pancreas in the stomach wall; of the intestine--jejunitis, ileocolitis, Crohn's disease, celiac disease, bacterial overgrowth syndrome in the small intestine; of biliary tract--cholelithiasis, gallbladder cholesterosis, anomalies of the biliary tract; of pancreas--acute and chronic pancreatitis, annular pancreas (2). The features of gastrointestinal diseases in children experiencing the action of factors, not always positively affecting the growing organism, were established. These features include: presence of allergic background; high level of neuro-autonomous and psycho-emotional changes in modern children, not only in schoolchildren, but even in preschoolers; polymorbidity or a combination (syntropy) of lesions of the digestive system; adverse outcomes of certain diseases as chronization, complications development, and as a consequence--a high risk of disability in children; "rejuvenation" of certain diseases of the digestive system (cholelithiasis, gallbladder cholesterosis, Crohn's disease), typical for adults. It is important to emphasize the clinical and social importance of gastroenterological diseases in childhood. Axiomatic is that the origins of many diseases of the digestive organs in adults lie in childhood. Early manifestation of certain diseases such as peptic ulcer disease, gluten enteropathy, Crohn's disease, and others, significantly impact the quality of life of sick children and their parents. It is worth to emphasize high costs of medical and prophylactic (tertiary prevention) activities using the drugs of latest generations. All this causes problems in both applied and scientific pediatric gastroenterology.

摘要

儿童消化系统疾病的命名法因“新”疾病而得到补充:食管方面——胃食管反流病(GERD)、巴雷特食管、Zenker憩室;胃和十二指肠方面——胃十二指肠炎症、消化性溃疡病、息肉、胃壁异位胰腺;肠道方面——空肠炎、回结肠炎、克罗恩病、乳糜泻、小肠细菌过度生长综合征;胆道方面——胆石症、胆囊胆固醇沉着症、胆道异常;胰腺方面——急性和慢性胰腺炎、环状胰腺(2)。已确定了儿童在受到并非总是对生长中的机体产生积极影响的因素作用时,其胃肠道疾病的特点。这些特点包括:存在过敏背景;现代儿童,不仅是学龄儿童,甚至学龄前儿童,神经自主和心理情绪变化程度高;消化系统病变的多器官发病或联合(协同作用);某些疾病的不良后果,如慢性病化、并发症发生,进而导致儿童残疾风险高;某些消化系统疾病(胆石症、胆囊胆固醇沉着症、克罗恩病)出现成人典型的“年轻化”。强调儿童胃肠病学疾病的临床和社会重要性很重要。许多成人消化器官疾病起源于儿童期,这是不言而喻的。某些疾病如消化性溃疡病、麸质肠病、克罗恩病等的早期表现,会显著影响患病儿童及其父母的生活质量。值得强调的是,使用最新一代药物进行医疗和预防(三级预防)活动成本高昂。所有这些在应用儿科胃肠病学和科学儿科胃肠病学方面都引发了问题。

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