Clinical Analysis Of 165 Children With Gastrointestinal Bleeding

Objective To analyze the clinical data of gastrointestinal bleeding in children of different ages,to explore its etiology distribution and clinical characteristics,and to provide a reference for clinical diagnosis and treatment of children with gastrointestinal bleeding.Methods Detailed clinical case data of 165 children with gastrointestinal bleeding diagnosed at Ningxia Medical University General Hospital from January 2012 to December2018 were collected and grouped into neonatal,infancy,early childhood,preschool and during the school age,the etiology and clinical features of gastrointestinal bleeding in children in each group were analyzed and summarized.Results1.General InformationA total of 165 children were collected in the study,including 117 males(70.90%),with a male to female ratio of 2.44:1,and the average age was 6.09 ± 4.50 years.Among these children,19 cases(11.52%)were newborn babies,17 cases(10.30%)were infants,18 cases(10.90%)were toddiers,39 cases(23.64%)were preschoolers,72 cases(43.64%)were schoolers.114 cases(69.09%)were from rural,51 cases(30.91%)were from towns,there were no difference with address(P>0.05).There were 78 cases(47.27%)with upper gastrointestinal hemorrhage,62 cases(37.58%)with lower gastrointestinal hemorrhage,16cases(9.70%)with total gastrointestinal bleeding,and 9 cases(5.45%)of gastrointestinal bleeding with unknown bleeding sites.The gastrointestinal bleeding site in different age groups varied significantly(P<0.05).The main manifestations expressed lowergastrointestinal hemorrhage were fastened on newborn babies and infants;the upper gastrointestinal hemorrhage and lower gastrointestinal hemorrhage both in toddiers and preschoolers were fair;the upper gastrointestinal hemorrhage were concentrated on schoolers.2.Clinical manifestationAmong these children,72 cases were hematemesis(43.63%),56 cases were black stools(33.94%),and 79 cases were dark red blood(47.88%).72 cases(43.63%)had hematemesis,27 cases(16.36%)had melena,and 79 cases had dark red bloody stools(47.88%),there were no significant difference between different age groups(P>0.05).The children had abdominal pain in 73 cases(44.24%)and abdominal distension in 7 cases(4.24%),the symptoms of abdominal pain and abdominal distension in different age groups had statistically significant differences(P<0.05),abdominal pain was mostly concentrated in children over 3 years old,bloating was more in the neonatal period.There were 71(43.03%)children with anemia,which could occur in all age groups,there was no significant difference between different age groups(P>0.05);13 cases of children with shock(7.88%),more neonatal occurred;33 cases Children with fever(20.00%),the difference between the different age groups was statistically significant(P<0.05),and fever was mainly concentrated in infants and newborn babies.3.Pathogeny distributionThe common causes of gastrointestinal bleeding in 165 cases were: gastroduodenal ulcer(25.45%),allergic purpura(12.73%),blood system disease(12.12%),Merkel diverticulum(10.91%),gastric duodenitis(7.88%)and esophageal varices(7.88%).Gastroduodenal ulcer,allergic purpura mainly occurred in schoolers(20%,12.73%,respectively).Blood system diseases in addition to preschoolers,the proportion of each age group is equivalent(neonatal3.03%,infancy 3.03%,preschool 2.42%,and during the school age 3.64%).The Merkel diverticulum occurs in infants(3.64%),early childhood(2.42%),and school-age children(3.64%).Gastric duodenitis mostly occurred in older children(2.42% in school age and3.64% in preschool age).Esophageal varices mainly occur in preschoolers(3.03%)and schoolers(4.24%).4.Discharge outcome of diseasesThe outcomes of 165 cases discharged from hospital were: 143 cases(86.67%)were improved,8 patients(4.85%)deteriorated,13 cases(7.88%)were ineffective,only 1 child died,the death rate is 0.61%.Conclusion1.Children with gastrointestinal bleeding have more male than female,upper gastrointestinal bleeding than lower gastrointestinal bleeding more common in preschoolers and schoolers.2.The main causes of gastrointestinal bleeding in children are: gastroduodenal ulcer,blood system diseases,allergic purpura and Meckel's diverticulum.3.In children,most of the gastrointestinal bleeding had a good outcome.