苏州市2007－2013年2岁以下儿童住院肠套叠流行特征

崔朋伟; 刘娜; 李静欣; 黄涛; 葛海霞; 武庆斌; 段招军

文章摘要

崔朋伟,刘娜,李静欣,黄涛,葛海霞,武庆斌,段招军.苏州市2007－2013年2岁以下儿童住院肠套叠流行特征[J].中华流行病学杂志,2016,37(3):410-414

苏州市2007－2013年2岁以下儿童住院肠套叠流行特征

Epidemiology of intussusception related hospitalizations in children aged <2 years in Suzhou, 2007-2013

收稿日期:2015-07-30 出版日期:2016-03-15

DOI：10.3760/cma.j.issn.0254-6450.2016.03.025

中文关键词: 肠套叠发病率儿童

英文关键词: Intussusception Incidence Children

基金项目:

作者	单位	E-mail
崔朋伟	102206 北京, 中国疾病预防控制中心病毒病预防控制所病毒性腹泻室
刘娜	102206 北京, 中国疾病预防控制中心病毒病预防控制所病毒性腹泻室
李静欣	102206 北京, 中国疾病预防控制中心病毒病预防控制所病毒性腹泻室
黄涛	102206 北京, 中国疾病预防控制中心病毒病预防控制所病毒性腹泻室
葛海霞	215000 苏州大学附属儿童医院消化内科
武庆斌	215000 苏州大学附属儿童医院消化内科	qingbin6638@aliyun.com
段招军	102206 北京, 中国疾病预防控制中心病毒病预防控制所病毒性腹泻室	zhaojund@126.com

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中文摘要:

目的了解苏州市<2岁儿童住院肠套叠流行状况及临床特征。方法回顾性收集苏州大学附属儿童医院2007年1月1日至2013年8月31日<2岁儿童住院肠套叠病例,采用描述性流行病学方法分析住院肠套叠发病率、病例年龄和季节分布及其临床特点等。采用Wilcoxon秩和检验比较年龄;采用简单线性回归分析发病年龄M和发病率的变化趋势;利用Origin 8.0软件对年龄和季节分布进行多项式拟合。结果共纳入<2岁儿童住院肠套叠594例,无死亡病例。平均年发病率为57.3(95%CI:52.8~62.1)/10万,其中<1岁儿童为100.6(95%CI:92.1~109.8)/10万。病例男女性别比为1.90 : 1,男性高于女性。<1岁病例占85.4%(507/594),且多集中于3~8月龄(66.2%,393/594),发病高峰为5~8月龄。发病年龄(M)为6.8(4.4)月龄,且由2007年的6.3(4.2)月龄增高至2013年的7.3(4.0)月龄,发病年龄M呈逐年增高趋势。住院病例中未观察到有明显的季节分布。主要临床表现为呕吐(83.2%,494/594),腹部包块(81.1%,482/594),血便(64.5%,383/594)。腹部超声检查(98.7%,586/594)为主要影像学诊断方法。手术为主要治疗方法(86.2%,512/594)。肠套叠发生部位以回-结肠型(34.5%,183/530)、回肠型(30.8%,163/530)或回-回-结肠型(27.9%,148/530)多见。结论苏州市<2岁肠套叠儿童病例发病率较高,应建立主动监测系统。

英文摘要:

Objective To understand the epidemiological and clinical characteristics of <2 years old children hospitalized due to intussusceptions. Methods Clinical and demographic data of <2 years old children hospitalized due to intussusception between January 2007 and August 2013 were retrospectively collected in Affiliated Children's Hospital of Soochow University in Suzhou. The incidence data, age distribution, seasonality and clinical characteristics of hospitalized intussusceptions cases were analyzed. Results A total of 594 intussusception-related hospitalizations were identified during this period in children aged <2 years, no death occurred. The crude incidence of hospitalized intussusception was 57.3 per 100 000 in children aged <2 years (95%CI: 52.8-62.1), and 100.6 per 100 000 in children aged <1 year (95%CI: 92.1-109.8). The male to female ratio was 1.90 : 1. Up to 85.4% (507/594) of the cases were aged <1 year, and 66.2% (393/594) of the cases were aged 3- 8 months. The incidence peaked in age group 5-8 months. The median age of the cases was 6.8 months (Q_R=4.4), and increased from 6.3 months (Q_R=4.2) in 2007 to 7.3 months (Q_R=4.0) in 2013. No obvious seasonality was observed. Main symptoms or signs included vomiting (83.2%, 494/594), abdominal mass (81.1%, 482/594), and bloody stool (64.5%, 383/594). Abdominal ultrasonic testing was the most frequently used diagnostic approach (98.7%, 586/594). Up to 86.2% (512/594) of patients were successfully treated by surgical intervention. The main sites for acute intussusception in children aged <2 years were ileo-colic (34.5%, 183/530), ileo-ileo (30.8%, 163/530) or ileo-ileo-colic (27.9%, 148/530). Conclusion The incidence of hospitalized intussusception in children aged <2 years was high in Suzhou. It is necessary to establish an active surveillance system to provide baseline data for the evaluation of rotavirus vaccine safety.

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