基于胃肠标记物胶囊诊断的不同分型功能性便秘患儿疗效差异分析-现代医学

基于胃肠标记物胶囊诊断的不同分型功能性便秘患儿疗效差异分析

作者：黄怡璇¹ 2 林谦² 陆妍² 沈毅² 李玫² 杨振华² 王猛² 金玉¹ 2 刘志峰¹ 2

单位：1. 南京大学医学院, 江苏南京 210093;
2. 南京医科大学附属儿童医院消化科, 江苏南京 210008

分类号：R816.92

出版年·卷·期（页码）：2023·51·第二期（156-162）

摘要：

目的：以胃肠标记物胶囊对功能性便秘患儿进行快速分型诊断，对不同类型功能性便秘患儿疗效差异进行分析。方法：选取2021年12月至2022年7月在南京医科大学附属儿童医院消化科就诊的功能性便秘患儿95例，其中男性患儿47例，女性患儿48例，平均年龄（6.93±2.75）岁。吞服一粒胃肠标记物胶囊，于72 h后拍摄腹部平片，观察胃肠标记物在结肠内的分布情况，对功能性便秘患儿行分型诊断。对不同类型便秘患儿行相同治疗2周后评估疗效，以便秘症状、生活质量及自我效能评估量表作为观察指标。结果：95例功能性便秘患儿中，慢传输型14例，出口梗阻型44例，正常传输型37例。问卷随访结果显示出口梗阻型与正常传输型便秘患儿的症状、生活质量及自我排便能力在治疗后较前改善（P<0.05）；而慢传输型便秘患儿的评估指标在治疗前后差异无统计学意义（P>0.05）。结论：胃肠标记物胶囊用于功能性便秘的分型具有良好的依从性和安全性，不同类型功能性便秘患儿常规治疗存在疗效差异。

Objective: To analyze the difference of therapeutic effect in children with different types of constipation by using gastrointestinal target radiopaque markers capsules which were used for rapidly subtyping functional constipation. Methods: In our study, from December 2021 to July 2022, a total of 95 functional constipated children were referred to the department of gastroenterology of Children's Hospital of Nanjing Medical University and underwent colonic transit test(CTT) by taking radiopaque markers capsule. There were 47 males and 48 females with a mean age of 6.93±2.75 years old. After taking the capsule for 72 hours, these patients were requested to take abdominal plain film to evaluate subtype constipation based on the pattern of transit. We separated the patients into 3 subtype constipation groups. For children who had completed CTT were advised to follow our treatment for 2 weeks. We evaluated the effect of our treatments with scales of PAC-SYM, PAC-QOL, and SEFCQ. Results: Among the 95 children with functional constipation, in terms of CTT subtype, there were 14 cases of slow transit constipation(STC), 44 of outlet obstruction constipation(OOC) and 37 of normal transit constipation(NTC). According to the follow-up questionnaires, children with OOC and NTC significantly improved after 2 weeks of treatment. However, no significant difference was found in the STC group. Conclusion: Applying gastrointestinal target radiopaque markers capsule has shown a great impact on patients' compliance and safety for subtype classification and treatment of children with functional constipation, which is of profound clinical significance in pediatric functional constipation management and treatment efficacy.

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