中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2010年
9期
656-660
,共5页
张树成%王维林%曲日斌%苏鹏俊%张世伟%张浩然%谭士勇%陈晓娟%张威%吴海涛%王剑利%何艳%董光辉
張樹成%王維林%麯日斌%囌鵬俊%張世偉%張浩然%譚士勇%陳曉娟%張威%吳海濤%王劍利%何豔%董光輝
장수성%왕유림%곡일빈%소붕준%장세위%장호연%담사용%진효연%장위%오해도%왕검리%하염%동광휘
功能性便秘,儿童%流行病学%诊断%中国人
功能性便祕,兒童%流行病學%診斷%中國人
공능성편비,인동%류행병학%진단%중국인
Functional constipation,child%Epidemiology%Diagnosis%Chinese
目的 探讨适用于我国儿童功能性便秘(FC)的症状学诊断标准.方法 应用分层、整群随机抽样方法对中国北方五市(北京、天津、沈阳、长春和哈尔滨)常住人口中4～14岁的儿童进行问卷调查,按儿童罗马Ⅲ标准筛选确定便秘组,了解便秘组和非便秘组各症状发生的频率并进行分析评价.结果 共发放问卷20 000份,回收19 638份(98.2%).便秘组1593例,非便秘组17 693例.χ2检验显示:排粪次数每周少于3次、粪干硬成团块状、每隔一段时间就有1次特别多的排粪、排粪费力且时间长、粪便带血、腹痛、腹胀等15个症状(包括上、下消化道及少数邻近器官症状)与便秘有关(P＜0.01和P＜0.05).Logistic回归分析显示:排粪次数每周少于3次、粪干硬成团块状、排粪费力和需要泻药协助排粪为最具显著性的症状(均P＜0.01).具备其中2条者的标准与儿童罗马Ⅲ标准具有较高的一致性,特异度和灵敏度分别为92.29%和94.85%,诊断准确率高达94.33%.结论 我国儿童FC的症状学诊断标准可考虑为:(1) 排粪次数每周少于3次;(2)粪干硬成团块状;(3)排粪费力;(4)需要泻药协助排粪.城市儿童在连续2个月内持续出现其中任意2条可初步考虑为FC.
目的 探討適用于我國兒童功能性便祕(FC)的癥狀學診斷標準.方法 應用分層、整群隨機抽樣方法對中國北方五市(北京、天津、瀋暘、長春和哈爾濱)常住人口中4～14歲的兒童進行問捲調查,按兒童囉馬Ⅲ標準篩選確定便祕組,瞭解便祕組和非便祕組各癥狀髮生的頻率併進行分析評價.結果 共髮放問捲20 000份,迴收19 638份(98.2%).便祕組1593例,非便祕組17 693例.χ2檢驗顯示:排糞次數每週少于3次、糞榦硬成糰塊狀、每隔一段時間就有1次特彆多的排糞、排糞費力且時間長、糞便帶血、腹痛、腹脹等15箇癥狀(包括上、下消化道及少數鄰近器官癥狀)與便祕有關(P＜0.01和P＜0.05).Logistic迴歸分析顯示:排糞次數每週少于3次、糞榦硬成糰塊狀、排糞費力和需要瀉藥協助排糞為最具顯著性的癥狀(均P＜0.01).具備其中2條者的標準與兒童囉馬Ⅲ標準具有較高的一緻性,特異度和靈敏度分彆為92.29%和94.85%,診斷準確率高達94.33%.結論 我國兒童FC的癥狀學診斷標準可攷慮為:(1) 排糞次數每週少于3次;(2)糞榦硬成糰塊狀;(3)排糞費力;(4)需要瀉藥協助排糞.城市兒童在連續2箇月內持續齣現其中任意2條可初步攷慮為FC.
목적 탐토괄용우아국인동공능성편비(FC)적증상학진단표준.방법 응용분층、정군수궤추양방법대중국북방오시(북경、천진、침양、장춘화합이빈)상주인구중4～14세적인동진행문권조사,안인동라마Ⅲ표준사선학정편비조,료해편비조화비편비조각증상발생적빈솔병진행분석평개.결과 공발방문권20 000빈,회수19 638빈(98.2%).편비조1593례,비편비조17 693례.χ2검험현시:배분차수매주소우3차、분간경성단괴상、매격일단시간취유1차특별다적배분、배분비력차시간장、분편대혈、복통、복창등15개증상(포괄상、하소화도급소수린근기관증상)여편비유관(P＜0.01화P＜0.05).Logistic회귀분석현시:배분차수매주소우3차、분간경성단괴상、배분비력화수요사약협조배분위최구현저성적증상(균P＜0.01).구비기중2조자적표준여인동라마Ⅲ표준구유교고적일치성,특이도화령민도분별위92.29%화94.85%,진단준학솔고체94.33%.결론 아국인동FC적증상학진단표준가고필위:(1) 배분차수매주소우3차;(2)분간경성단괴상;(3)배분비력;(4)수요사약협조배분.성시인동재련속2개월내지속출현기중임의2조가초보고필위FC.
Objective To explore the symptomatic criteria for diagnosis in children with functional constipation(FC) in North China. Methods A screening program for FC in children was carried out in 5 northern cities (Beijing, Tianjin, Shenyang, Changchun, Harbin) of China according to symptoms using RomeⅢ criteria. Random clustered sampling of the inhabitants was carried out under stratification of city, region and school or kindergarten. Sample size of each area was in proportion to the population of the area. The range of age was 4-14. All the subjects were requested to fill in a questionnaire distributed by the teacher. The screening program was carried out immediately after a plot survey. A total of 20,000 questionnaires were distributed and 19,638 retrieved. According to the result of the screening, a small number of patients who fulfilled the criteria were further selected to undergo detail clinical examinations in the hospital including laboratory examination, colonic transit time, defecography or/and barium enema, electromyologram and anorectal manometry to exclude organic disease of the colon. A detailed questionnaire was filled in with the assistance from a trained doctor or a medical student. Potential risk factors and the relative symptoms were explored by comparing frequencies between FC group and non-FC group using χ2 and Logistic analysis. Results Eighteen symptoms (defecation less than 3 times per week, dry hard sausage-shape stool, difficulty in defecation, abdominal pain, nausea and vomiting, etc) could exist in control group, but FC group had a higher frequency. The difference was statistically significant. Multivariable stepwise logistic regression analysis showed that defecation less than 3 times per week, hard sausage-shape feces, difficulty in defecation, and the need for laxative were associated with FC. The absence of other symptoms had no influence on diagnosis of FC. The sensitivity, specificity and diagnostic accuracy of symptomatic standard diagnostic test based on RomeⅢ criteria in FC children showed that ≥2 items had the best diagnostic accuracy but moderate sensitivity and specificity. Conclusion The symptomatic criteria for FC diagnosis in children are sugge
