小儿纤维结肠镜检查133例分析

摘要

探讨纤维结肠镜在小儿的应用特点.133例便血患儿行纤维结肠镜检查,男74例,女59例;年龄最小1岁,最大14岁,平均5.8岁.均在静注氯胺酮(1 mg/kg)静脉全麻下镜检.诊断直肠、结肠息肉90例,胃肠道多发性息肉病4例,直肠血管瘤1例,巨结肠术后"Z"形吻合口肉芽出血1例,慢性结肠炎12例,全结肠未见异常25例(其中12例经手术证实为回肠美克尔憩室,1例为小肠内瘘,其余12例便血原因不明).单发息肉主要分布在乙状结肠(46例,占55.4%)和直肠(19例,占22.9%).行息肉电切术86例,其中84例电凝、电切指数均分别控制在3.0～3.5和2.5～3.0范围内,切除息肉103枚.全部患儿治愈.便血是小儿结肠镜检查的主要适应证.在镇静状态下镜检安全可靠,无肠穿孔等并发症的发生.%Fibercoloscopy was performed on 133 children(male 74,female 59)with rectal bleeding.age ranged from 1 to 14 years,with an average of 5.8 years.Ketamine(1 mg/kg)was injected intravenously for fiberscopic examination.There were rectal and colonic polyps in 90 cases,multiple polyposis in 4;rectal hemangioma in 1;bleeding of anastomosis granulation after surgery for Hirschsprung's disease in 1;chronic colitis in 12 and normal colonic findings in 25 (including:Meckel's diverticulum in 12;small intestinal fistula in 1;and unknown cause bleeding in 12).Those with simple polypi chiefly in sigmoid(46 cases,55.4%)and rectum(19 cases,22.9%).Totally 86 underwent electrocision.The electrocoagulation index was regulated from 3.0 to 3.5 while electrotomy index from 2.5 to 3.0.103 polypi were removed with satisfactory results.Rectal bleeding is the main indication of fibercoloscopy in children.Fibercoloscopy procedures can be performed safely on small patients under sedation.