小儿慢性迁延性腹泻102例病因分析与治疗对策探讨

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目的:分析小儿慢性迁延性腹泻病的病因、临床特点及治疗对策。方法:对2012年8月至2013年8月在我院住院并诊断为迁延性慢性腹泻病的102例患儿的临床资料进行回顾性分析。结果:主要病因包括食物过敏26例(25.5%),感染28例(27.5%)[其中细菌感染21例(20.6%),病毒感染7例(6.9%)],肠道菌群失调24例(23.5%),乳糖不耐受22例(21.6%),食物不耐受6例(5.9%),小肠淋巴管扩张症1例(1.0%),炎症性肠病1例(1.0%),另有5例病因不明。主要并发症包括水电解质平衡紊乱(6.9%)、营养不良(4.9%)、贫血(3.9%)、佝偻病激期(1.0%)、严重低蛋白血症(1.0%)。治疗方法主要包括病因治疗、补液及支持、饮食及对症治疗;17例使用了抗菌药物,占16.7%。全部患儿均治愈好转,无死亡病例。结论:小儿慢性迁延性腹泻病因复杂多样化,其中食物过敏因占较大比例,临床表现多样,并发症多,治疗困难;饮食及支持治疗等多途径联合治疗,合理使用抗菌药物,可减少并发症、缩短病程,获得良好疗效。 Objective: To analyze the etiology, clinical features and treatment of children with chronic persistent diarrhea. Methods: The clinical data of 102 children hospitalized in our hospital from August 2012 to August 2013 and diagnosed as persistent chronic diarrhea were analyzed retrospectively. Results: The main causes were food allergy in 26 cases (25.5%), infection in 28 cases (27.5%) [bacterial infection in 21 cases (20.6%), viral infection in 7 cases (6.9%)], intestinal flora dysfunction in 24 cases 23.5%), lactose intolerance in 22 cases (21.6%), food intolerance in 6 cases (5.9%), intestinal lymphangiectasis in 1 case (1.0%), inflammatory bowel disease in 1 case There are 5 cases of unknown etiology. The main complications were water and electrolyte balance disorders (6.9%), malnutrition (4.9%), anemia (3.9%), rickets exacerbation (1.0%) and severe hypoproteinemia (1.0%). Treatment includes etiology, rehydration and support, diet and symptomatic treatment; 17 cases used antimicrobial drugs, accounting for 16.7%. All children were cured and no deaths. Conclusions: The causes of chronic persistent diarrhea in children are complex and diversified. Among them, food allergy accounts for a large proportion, clinical manifestations are diverse, complications are complicated, and treatment is difficult. Combined treatment of diet, supportive therapy and many other ways can reduce the incidence of complications Symptoms, shorten the course of the disease, access to good effect.
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