The Clinical Analysis Of 66 Pediatric Patients With Digestive Tract Hemorrhage

Objective:To analyze and summarize the clinical data and the experiences of diagnosting and treating children with the digestive tract hemorrhage in different age.To explore the important role of the gastroendoscope and other examination in the process of diagnostics and treatment. To give the help for diagnosting and treating children with the digestive tract hemorrhage in different age.Methods:The clinical detail data of 66 pediatric patients with digestive tract hemorrhage were collected, analysed and studied retrospectively in the department of pediatrics in the First Affiliated Hospital of Kunming Medical University from January 2014 to January 2016 and. According to age, the patients was divided into four groups as infants, young children, preschool and school age group. According to anatomy, the patients was divided into two groups as the upper(stomach and duodenum) and lower (small and large intestine) digestive tract hemorrhage.Results:1.The patients with alimentary tract hemorrhage is 66 case(male 45 and female 21), and the male to female gender ratio is 2.14:1. The proportion of the infancy, early childhood, preschool and school-age group is 18.1%、6.1%、9.1% and 66.7% respectively.2.48 patients with alimentary tract hemorrhage under the endoscopy were diagnosed. Some of patients were of by two or more kinds of gastroendoscope examinations. The rate of the patients under endoscope is 79.5%. Among the patients with gastrointestinal hemorrhage,18.2% of patients were diagnosed by Single Photon Emission Computed Tomography(SPECT),13.6% of patients were Hp infection by 13C breath test.88.9% of children at school age were by 13C breath test,21.9% of patients were positive.3. The proportion of upper digestive tract hemorrhage, lower digestive tract hemorrhage, both, and failed to find out the digestive tract hemorrhage was 43.9%,31.8%,15.2% and 9.1% respectively among 66 patients with gastrointestinal hemorrhage.4.The most common diseases among the infancy, early childhood, preschool and school-age group are the food protein-induced enterocolitis syndrome , (FPIES) intestinal polyp, intestinal polyps and chronic superficial gastritis, the most common diseases among school-age patients are chronic superficial gastritis, duodenitis, anaphylactoid purpura, Meckels diverticulum, duodenal ulcer.Conclusion:1 There are differrnces in the part of the gastrointestinal hemorrhage and clinical manifestations in children of different ages.FPIES cause lower digestive tract hemorrhage most common etiology in infancy.The most common performance in infancy is chronic blood loss with bloody stool.The most common disease in the school-age group are the chronic superficial gastritis, duodenitis, anaphylactoid purpura, Meckel’s diverticulum, duodenal ulcer which is cause upper digestive tract hemorrhage. Acute blood loss common performance are hematemesis, melena and bellyache.2.Gastroendoscope association SPECT and 13C-urea breath test is important in diagnosis and treatment of children’s digestive tract hemorrhage.3.It is important to combine medical-surgical in the difficulty of diagnosis and treatment of children digestive tract hemorrhage is very necessary.