儿童慢性腹泻病因分析

目的探讨儿童慢性腹泻的病因,以提高临床诊治水平。方法选择2005年12月至2010年12月在重庆医科大学附属儿童医院住院的141例慢性腹泻患儿为研究对象,对患儿的临床资料进行回顾性分析。结果本组病例中常见致病因素依次为过敏因素46.2%(24/52)、肠道内感染28.4%(40/141)、乳糖不耐受28.3%(26/92)。共109例明确病因诊断,55.1%(60/109)为多因素共同致病,以肠道内感染合并继发乳糖不耐受,过敏合并继发乳糖不耐受,免疫缺陷合并肠道内感染多见。前4位主要病因诊断为感染性腹泻(24.1%)、过敏性腹泻(17.0%)、乳糖不耐受(7.1%)、炎症性肠病(6.4%)。结论除肠道内感染外,过敏因素、乳糖不耐受等也是儿童慢性腹泻常见致病因素。儿童慢性腹泻常由多因素共同致病,主要病因除感染性腹泻外,过敏性腹泻、乳糖不耐受、炎症性肠病等也是常见病因。儿童慢性腹泻重在病因诊断,针对病因治疗。

Cause analysis of children with chronic diarrheal disease

Objective To explore the causes of chronic diarrheal diseases in children in order to improve the level of diagnosis and treatment in clinical work. Method Clinical data of 141 cases with chronic diarrheal diseases hospitalized in Children＇s Hospital of Chongqing Medical University between December 2005 and December 2010 were reviewed retrospectively. Result The common pathogenic factors included allergy in 24 cases （24/52, 46.2% ）, intestinal infection in 40 cases （40/141,28.4%）, lactose intolerance in 26 cases （26/92, 28.3% ）. There were 109 cases etiological diagnosed clearly, and 55.1% （60/109） of these cases were multi-factors. The most common multi-factors were intestinal infection with secondary lactose intolerance, allergy with secondary lactose intolerance, and immunodeficiency with secondary intestinal infection. The first 4 main diagnosed causes of these cases were infectious diarrhea （24.1%）, allergic diarrhea （ 17.0% ）, lactose intolerance （7.1%） and inflammatory bowel diseases （6.4%）. Condusion Intestinal infection, allergic factors, lactose intolerance were common pathogenic factors. Most of the dearly diarrheal were multi-factors. Infectious diarrhea, allergic diarrhea, lactose intolerance, and inflammatory bowel disease were the main causes of CDD. The etiologic diagnosis of CDD is the key for the treatment .