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儿童肠系膜淋巴结病的临床评估与结局:一项横断面分析

Clinical Evaluation and Outcomes of Mesenteric Lymphadenopathy in Children: A Cross-Sectional Analysis.

作者信息

Yukcu Bekir, Yildirmak Zeynep Yildiz, Ozel Alper, Genc Dildar Bahar

机构信息

Department of Pediatric Cardiology, Giresun Obstetric and Pediatric Training and Research Hospital, Giresun, Türkiye.

Department of Pediatric Hematology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.

出版信息

Sisli Etfal Hastan Tip Bul. 2025 Mar 18;59(1):127-133. doi: 10.14744/SEMB.2025.59752. eCollection 2025.

Abstract

OBJECTIVES

This study aimed to evaluate the etiology, clinical characteristics, and outcomes of mesenteric lymphadenopathy (ML) in children, with an emphasis on its clinical significance and management strategies.

METHODS

This cross-sectional, single-center study was conducted between July 2016 and May 2017 and included pediatric patients aged 1 month to 18 years diagnosed with ML via abdominal ultrasonography. Patients with malignancies, acute infections, ongoing corticosteroid or antibiotic treatment, or incomplete follow-up were excluded. Data collection included demographic, clinical, and laboratory findings. Statistical analyses were performed using IBM SPSS Statistics version 25. The Mann-Whitney U test was used for comparisons of numerical variables between groups, while the chi-square and Fisher's exact tests were applied for categorical variables. A p-value less than 0.05 was considered statistically significant.

RESULTS

A total of 106 patients were included with a median age of 7.4 years (range: 8 months-16.4 years), of whom 55.7% were male. The majority (63%) were aged 6-11 years. Abdominal pain was the most common symptom (64.2%), and 99.1% of the ML cases were localized in the right lower quadrant. At 1-month follow-up, lymph node sizes regressed to normal in 71.7% of cases, while 28.3% remained pathological. Antibiotic use did not significantly affect lymph node regression. At 6 months, no new symptoms or diagnoses were reported in the 91 patients contacted. ML was most often idiopathic (76.4%), with secondary causes including gastrointestinal and respiratory infections, acute abdomen, and Familial Mediterranean Fever.

CONCLUSION

In children, ML is predominantly benign and self-limiting, and in most cases, it resolves without medical intervention. Although its association with symptoms such as abdominal pain may cause anxiety in parents, careful monitoring of patients can prevent unnecessary interventions. This study underscored the importance of conservative management and highlighted the need for further research with larger cohorts and extended follow-up periods to explore rare etiologies and long-term outcomes.

摘要

目的

本研究旨在评估儿童肠系膜淋巴结病(ML)的病因、临床特征及预后,重点关注其临床意义和管理策略。

方法

本横断面单中心研究于2016年7月至2017年5月进行,纳入了通过腹部超声诊断为ML的1个月至18岁儿科患者。排除患有恶性肿瘤、急性感染、正在接受皮质类固醇或抗生素治疗或随访不完整的患者。数据收集包括人口统计学、临床和实验室检查结果。使用IBM SPSS Statistics 25版进行统计分析。Mann-Whitney U检验用于比较组间数值变量,而卡方检验和Fisher精确检验用于分类变量。p值小于0.05被认为具有统计学意义。

结果

共纳入106例患者,中位年龄为7.4岁(范围:8个月至16.4岁),其中55.7%为男性。大多数(63%)年龄在6至11岁。腹痛是最常见的症状(64.2%),99.1%的ML病例位于右下腹。在1个月的随访中,71.7%的病例淋巴结大小恢复正常,而28.3%仍为病理性。使用抗生素对淋巴结消退没有显著影响。在6个月时,联系的91例患者中未报告新的症状或诊断。ML最常见的原因是特发性(76.4%),次要原因包括胃肠道和呼吸道感染、急腹症和家族性地中海热。

结论

在儿童中,ML主要是良性和自限性的,在大多数情况下,无需医疗干预即可缓解。尽管它与腹痛等症状的关联可能会使家长焦虑,但对患者进行仔细监测可避免不必要的干预。本研究强调了保守管理的重要性,并突出了需要进行更大样本队列和更长随访期的进一步研究,以探索罕见病因和长期预后。

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