Wang En-Hui, Sun Mei
Department of Pediatric Gastroenterology, Shengjing Hospital Affiliated to China Medical University, Shenyang 110000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Apr 15;24(4):372-376. doi: 10.7499/j.issn.1008-8830.2201003.
To study the clinical manifestations and gastroscopic characteristics of upper gastrointestinal ulcer in children.
A retrospective analysis was performed for the children who underwent gastroscopy and were found to have upper gastrointestinal ulcer for the first time at the Endoscopy Center of Shengjing Hospital, China Medical University, from January 2011 to May 2021. According to the cause of the disease, they were divided into primary ulcer group (primary group; =148) and secondary ulcer group (secondary group; =25). The clinical data were compared between the two groups.
A total of 173 children with upper gastrointestinal ulcer were enrolled, with a male/female ratio of 3.9:1. Compared with girls, boys had significantly higher proportions of duodenal ulcer and primary ulcer (<0.05). Compared with the children aged below 6 years, the children aged 6-14 years had higher proportions of duodenal ulcer and primary ulcer and lower proportions of giant ulcer and multiple ulcers. Of the 148 children in the primary group, 95 (64.2%) had infection. Abdominal pain was the most common clinical symptom and was observed in 101 children (68.2%). Duodenal ulcer was common and was observed in 115 children (77.7%), followed by gastric ulcer in 25 children (16.9%) and esophageal ulcer in 7 children (4.7%). Multiple ulcers were observed in 32 children (21.6%). Seventy children (47.3%) experienced complications, among which bleeding was the most common complication and was observed in 63 children (43.6%). Of the 25 children in the secondary group, abdominal pain was the most common clinical symptom and was observed in 9 children (36.0%), with a significantly lower incidence rate than the primary group (<0.05); foreign body in the digestive tract was the most common cause of ulcer and was observed in 17 children (68%), followed by abdominal Henoch-Schönlein purpura in 5 children (20.0%) and Crohn's disease in 3 children (12.0%). The secondary group had a significantly higher proportion of multiple ulcer or giant ulcer than the primary group (<0.05).
Upper gastrointestinal ulcer is more common in boys than girls, and duodenal ulcer and primary ulcer are more common in boys. Children aged 6-14 years often have duodenal ulcer and primary ulcer, and giant ulcer and multiple ulcers are relatively uncommon. Primary ulcer in children has a variety of clinical manifestations, mainly abdominal pain, and duodenal ulcer is relatively common, with bleeding as the main complication. The clinical symptoms and endoscopic manifestations of secondary ulcer are closely associated with the primary causes, and it is more likely to induce huge ulcers and multiple ulcers.
研究儿童上消化道溃疡的临床表现及胃镜特征。
对2011年1月至2021年5月在中国医科大学附属盛京医院内镜中心首次接受胃镜检查并被诊断为上消化道溃疡的儿童进行回顾性分析。根据病因将其分为原发性溃疡组（原发性组；n = 148）和继发性溃疡组（继发性组；n = 25）。比较两组的临床资料。
共纳入173例上消化道溃疡患儿，男女比例为3.9∶1。与女孩相比，男孩十二指肠溃疡和原发性溃疡的比例显著更高（P<0.05）。与6岁以下儿童相比，6～14岁儿童十二指肠溃疡和原发性溃疡的比例更高，巨大溃疡和多发溃疡的比例更低。原发性组148例患儿中，95例（64.2%）有幽门螺杆菌感染。腹痛是最常见的临床症状，101例患儿（68.2%）出现腹痛。十二指肠溃疡最为常见，115例患儿（77.7%）出现十二指肠溃疡，其次是胃溃疡25例（16.9%），食管溃疡7例（4.7%）。32例患儿（21.6%）出现多发溃疡。70例患儿（47.3%）发生并发症，其中出血是最常见的并发症，63例患儿（43.6%）出现出血。继发性组25例患儿中，腹痛是最常见的临床症状，9例患儿（36.0%）出现腹痛，发病率显著低于原发性组（P<0.05）；消化道异物是溃疡最常见的病因，17例患儿（68%）出现消化道异物，其次是腹型过敏性紫癜5例（20.0%），克罗恩病3例（12.0%）。继发性组多发溃疡或巨大溃疡的比例显著高于原发性组（P<0.05）。
上消化道溃疡在男孩中比女孩更常见，男孩十二指肠溃疡和原发性溃疡更常见。6～14岁儿童常患十二指肠溃疡和原发性溃疡，巨大溃疡和多发溃疡相对少见。儿童原发性溃疡有多种临床表现，主要为腹痛，十二指肠溃疡相对常见，出血是主要并发症。继发性溃疡的临床症状和内镜表现与原发病因密切相关，更容易诱发巨大溃疡和多发溃疡。
