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目的分析小儿嗜酸细胞性胃肠炎(EG)的临床特点、诊断要点、治疗预后和误诊原因。方法本院2006-2008年收治EG患儿11例,对其病史、临床特点、实验室检查、内镜表现和治疗、随访情况进行回顾性分析,应用SPSS10.0软件进行统计学分析。结果1.EG患儿的临床表现多样,包括腹痛(5例)、腹泻(7例)、便血(5例)、低热(2例)等。2.EG患儿中54.55%的过敏体质与EG发病密切相关。3.所有患儿中,18.18%外周血中嗜酸性粒细胞(EOS)计数增高明显,可随症状缓解而下降。4.患儿内镜表现均无明显特异性,可见到黏膜片状糜烂、浅溃疡、散在充血斑或出血点,以胃窦、十二指肠、回肠末端、回盲部最明显,活检可见大量EOS浸润。5.影像学检查无特异性,10例(90.91%)黏膜型CT或消化道钡餐检查无特殊发现,1例(9.09%)肌型肠壁肌层受累时见不全梗阻。6.激素为治疗EG的一线药物,可迅速缓解症状,并使EOS恢复正常。7.本病是一种自限性变应性疾病,虽可反复发作,但长期随访未见恶变,多数预后良好。结论EG的临床表现和内镜表现均无特异性,胃肠黏膜组织中EOS增多是诊断的关键。本病极易造成误诊,明确诊断需依靠活组织病理检查,并结合临床特点来证实。
Objective To analyze the clinical features, diagnosis, prognosis and misdiagnosis of pediatric eosinophilic gastroenteritis (EG). Methods A total of 11 children with EG were admitted to our hospital from 2006 to 2008, and their clinical history, clinical features, laboratory tests, endoscopic findings, treatment and follow-up were retrospectively analyzed. SPSS 10.0 software was used for statistical analysis. Clinical manifestations of 1.EG children with various, including abdominal pain (5 cases), diarrhea (7 cases), blood in the stool (5 cases), fever (2 cases). 2.EG in children with 54.55% of the allergy is closely related with the pathogenesis of EG. 3. All children, 18.18% of peripheral blood eosinophils (EOS) count increased significantly, with the symptoms can be alleviated. There was no obvious specificity in children with endoscopic findings, we can see mucosal laminar erosions, shallow ulcers, scattered congestion spots or bleeding points to the antrum, duodenum, ileum, ileocecal most obvious biopsy visible A large number of EOS infiltration. No specific imaging examination, 10 cases (90.91%) mucosal CT or gastrointestinal barium meal examination found no special findings, 1 case (9.09%) muscular intestinal wall involvement involved in obstruction. 6. Hormone is the first-line drug for the treatment of EG, which can quickly relieve symptoms and return EOS to normal. 7. The disease is a self-limiting allergic disease, although recurrent, but no long-term follow-up malignant, most of the prognosis is good. Conclusion The clinical manifestations and endoscopic findings of EG are nonspecific. The increase of EOS in gastrointestinal mucosa is the key point of diagnosis. The disease can easily lead to misdiagnosis, a clear diagnosis depends on biopsy, and combined with clinical features to confirm.