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目的探讨吞气症的诊断和治疗。方法收集本院2005年7月-2009年3月收治的吞气症患儿20例。男12例,女8例;年龄2～13岁。通过询问病史、体格检查、实验室检查,排除器质性疾病。对其临床资料进行回顾性分析。结果吞气症患儿20例,均符合儿童功能性胃肠病罗马Ⅲ诊断标准。临床主诉为腹胀20例(100%),可以见不自主的吞气现象20例(100%),频繁嗳气、食欲不振各18例(各占90%),便秘12例(60%),有心理压力8例(40%),反复腹痛6例(30%),慢性腹泻、急性腹痛各2例(各占10%)。查体:腹部明显隆起,触诊腹部柔软,无压痛,无包块,叩诊可闻及鼓音,听诊肠鸣音活跃或亢进。影像学检查显示胃肠道有大量气体,无液平面。经血尿粪常规、大便培养、肠道病毒和血生化等检查,排除感染、电解质紊乱和外科疾病。14例(70%)患儿经心理疏导、饮食调节,适当的通便药、胃肠动力药和多种维生素治疗后痊愈。6例(30%)严重者经上述治疗无效,口服硅油类药物(二甲硅油和西甲硅油)治疗效果好。结论儿童吞气症为功能性疾病。部分患儿伴精神方面异常,无精神方面异常的患儿吞气症通常为自限性,吞气现象持续数周或数月,但也可能持续更长时间。硅油类药物可以减轻儿童吞气症的临床症状,缩短其病程。
Objective To investigate the diagnosis and treatment of swallowing. Methods Twenty patients with swallowed gas were collected from our hospital from July 2005 to March 2009. 12 males and 8 females; aged 2 to 13 years old. By asking history, physical examination, laboratory tests, excluding organic disease. The clinical data were retrospectively analyzed. Results 20 cases of swallowed children, all in line with children with functional gastrointestinal Rome Ⅲ diagnostic criteria. The main complaint was abdominal distension in 20 cases (100%), 20 cases (100%) with involuntary swallowing, 18 cases (90%) with frequent belching and loss of appetite, 12 cases (60%) with constipation, There were 8 cases of psychological stress (40%), 6 cases of recurrent abdominal pain (30%), 2 cases of chronic diarrhea and acute abdominal pain (10% each). Physical examination: abdominal obvious bulge, tender palpation tenderness, no tenderness, no mass, percussion can be heard and drum sound, auscultatory bowel sounds active or hyperthyroidism. Imaging examination revealed a large number of gastrointestinal gas, no liquid level. Regular menstrual blood and urine, stool culture, enterovirus and blood biochemistry and other tests to rule out infection, electrolyte disorders and surgical diseases. Fourteen (70%) children recovered after psychological counseling, dietary modification, appropriate laxatives, gastrointestinal motility and multivitamins. Six patients (30%) were treated with the above mentioned ineffective treatment. Oral silicone oil (simethicone and simethicone) was effective. Conclusion Child swallowing disease is a functional disease. Some children with mental abnormalities, non-mental abnormalities in children swallowing disease is usually self-limiting, swallowing phenomenon lasts for several weeks or months, but may also last longer. Silicone oil drugs can reduce the symptoms of swallowing children, shorten the course.