| Objective A retrospective analysis of 331 cases of children with Hematochezia was carried out to explore the cause of hematochezia in children and its related influencing factors,so as to improve the understanding of the cause of hematochezia in children,assist in clinical diagnosis and treatment,and improve the prognosis of the disease.Methods 331 children aged 0-16 years with Hematochezia were admitted to the Department of Gastroenterology and Surgery of the Children’s Hospital affiliated to Anhui Medical University from December 2018 to December 2021.SPSS22.0software was used to retrospectively analyze the clinical data of the patients.Results 1.331 cases,male 204 cases(61.6%),female 127 cases(38.4%),the ratio of male to female 1.61:1.00.The ratio of male to female was 1.65%.There were 82 cases(24.5%)in the neonatal group,71 cases(21.5%)in the infant group,70 cases(21.1%)in the preschool group,69 cases(20.9%)in the school-age group,and 39 cases(11.6%)in the youth group.2.Among the 331 cases,103 cases(31.1%)were accompanied with diarrhea,42 cases(12.7%)with fever,39 cases(11.8%)with hematemesis,125 cases(37.8%)with abdominal pain,22 cases(6.6%)with shock There were 145 cases(43.8%)of bloody stool,46 cases(13.9%)of dark red bloody stool,53 cases(16.0%)of bloody stool and49 cases(14.8%)of mucous bloody stool,there were 38 cases(11.5%)with black stool.3.Among the 331 cases,164 cases(49.5%)had normal WBC,258 cases(78.0%)had normal N%,274 cases(82.8%)had normal L%,and 253 cases(76.3%)had normal EOS%,there were 112(33.8%)children with normal HGB,157(47.4%)children with visible white blood cells,159(48.0%)children with visible red blood cells,and262(79.1%)children with positive occult blood test,there were 110(33.2%)children with positive stool culture,131(39.6%)children with normal PT,123(37.2%)children with normal APTT and 125(37.8%)children with normal FIB,136 cases(41.1%)had normal platelet count.4.Of the 331 children,91(27.5%)had UGIB,204(61.6%)had LGIB,and 36(10.9%)had OGIB The leading causes were infectious diarrhea,intestinal polyps,allergic proctitis(FPIAP),colitis and eosinophil granulocyte colitis(EOC).Of these,106(32.0%)were due to intestinal polyps,61(18.4%)were due toinfectious diarrhea,40(12.1%)were due to FPIAP,39(11.8%)were due to colitis,and 34(10.3%)were due to EOC,there were 51 cases(15.4%)with other causes.5.There were significant differences in the constituent ratio of the causes of hematochezia in children of different ages(χ~2 = 29.195,p = 0.023),but there were no significant differences in the constituent ratio of the causes of hematochezia in children of different sexes(χ~ 2= 0.471,p = 0.976)There was a significant difference in the cause of hematochezia in children with different feeding history(χ~ 2= 57.541,p <0.001),and there was a significant difference in the cause of hematochezia in children with different feeding history(χ~2= 26.025,p = 0.001)There was significant difference in the etiology of hematochezia among children with different family history(χ~ 2=16.358,P = 0.003).6.There were significant differences in FPIAP,colitis and EOC eosinophil granulocyte(χ~2 = 29.195,P = 0.023).7.331 on discharge,330 children were cured and discharged,even though their blood symptoms disappeared,and one child died of very early inflammatory bowel disease with immunodeficiency.Conclusion The main causes of hematochezia in this group were intestinal polyps,infectious diarrhea,FPIAP,colitis and EoC.The etiology of hematochezia is complex and varied,and the etiology of hematochezia is closely related to age.Infantile hematochezia is easy to be misdiagnosed and misdiagnosed,and the misdiagnosis rate of allergic enteritis and intestinal vascular malformation tops the list.It is of great significance to strengthen clinicians’ understanding of infantile hematochezia.Different age,different course of disease,different feeding history,different family history of hematochezia cause composition is different.In order to reduce missed diagnosis and misdiagnosis and strengthen the understanding of the diseases that can cause hematochezia,it is of great significance to improve relevant examinations as soon as possible after proper evaluation to clarify the etiology and diagnosis.If the cause of stool blood volume is unknown and the bleeding is difficult to control,MRI,enhanced CT,DSA examination and even surgical exploration should be improved when necessary. |
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