| Objective: To summarize the clinical characteristics of gastrointestinal bleeding in children at different ages and to explore the etiology,so as to provide a basis for standardizing the diagnosis and treatment of gastrointestinal bleeding.Methods: The information of 1287 children diagnosed with GIB in the inpatient department of Anhui Children’s Hospital from May 2017 to April 2021 was collected.They were divided into two groups according to gender,five groups according to the age of admission and four groups according to the season of onset.Record and sort out the children’s name,age,gender,time of admission,clinical symptoms and combined diseases,and summarize the characteristics of each information.The relationship between the top eight main causes and various factors was analyzed,and the constitutive changes of the main causes of GIB in the past four years were compared.All the data were processed using SPSS 25.0 statistical software.The count data were expressed in frequency and percentage.The comparison between groups used chi-square test,P <0.05,the difference was statistically significant.Results:1.Basic information: There were 1287 cases,including 797 males and 490 females,with a male-to-female ratio of 1.63:1.Among the cases,infant group accounted for53.92%（694/1287）,toddler group accounted for 10.64%（137/1287）,preschool group accounted for 15.23%（196/1287）,school-age group accounted for 12.59%（162/1287）,and adolescent group accounted for 7.61%（98/1287）.Among the cases,the spring group included 273 cases（21.21%）,the summer group included 319 cases（24.79%）,the autumn group included 336 cases（26.11%）,and the winter group included 359（27.89%）.There were statistically significant differences in the onset of season in children among different age groups（P <0.05）.The onset season of children in the toddler group and preschool group was mostly in winter,and the school-age children were slightly more common in autumn,while the incidence of children in the infant group and the adolescent group was basically flat in each season.2.Clinical symptom: The symptoms of gastrointestinal bleeding in children were hematemesis（41.49%）,melena（15.70%）,and hematochezia（38.46%）.The symptoms of different ages were statistically significantly different（P<0.05）.Hematemesis was mostly concentrated in toddler and preschool age,melena was more common in older children,hematochezia was much more common in infancy.Fever occurred in 283cases（21.99%）.There were no statistical differences between the age groups（P>0.05）.Abdominal pain occurred in 318 cases（24.71%）,and abdominal distension occurred in75 cases（5.83%）.The age groups were significantly different（P<0.05）.Abdominal pain was more common in children over 3 years old,the bloating was concentrated in infancy.3.Etiological distribution: The frequent common causes of GIB in 1287 children were gastritis（36.05%）,hematological diseases（10.80%）,HSP（10.72%）,enteritis（8.78%）,gastrointestinal malformation（5.52%）,PU（3.96%）,FA（2.41%）and EGV（2.33%）.The top three causes of each age group were: gastritis,hematological diseases,enteritis of infant group;gastritis,gastrointestinal malformation,hematological diseases of toddler group;HSP,gastritis,gastrointestinal malformation of preschool group;HSP,gastritis,PU of school-age group;HSP,gastritis,PU of adolescent group.4.Analysis of the main etiology: There were statistical differences in gender,age,onset season and clinical symptoms.5.Cause change: In the past four years,gastritis was the most common cause of children with GIB in our hospital.The proportion of hematological diseases was decreasing year by year,the proportion of PU was on the rise,and there were no obvious changes in other causes.Conclusion:1.In this study,pediatric GIB were more men than women,more common in infancy,and slightly more common in autumn and winter.The occurrence of GIB is related with gender,age,season,and the diseases causing GIB vary in clinical manifestations.2.The main diseases of childhood GIB were gastritis,hematological diseases,HSP,enteritis,gastrointestinal malformations,PU,FA and EGV.It has reference significance for the diagnosis of clinical upper gastrointestinal bleeding. |
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