目的 了解不同月龄婴儿常见胃肠道症状的流行情况,为临床门诊开展胃肠道常见问题筛查、干预和咨询指导服务提供依据。方法 在我国的东、中、西部选择15个主要城市,采用整群抽样的方法在每个城市单纯随机抽样选择一个或多个社区作为样本区,开展横断面调查。调查对象为1~12月龄婴儿,对婴儿抚养人进行面对面问卷调查。结果 调查共收集婴儿4 202例,1 411例存在胃肠道问题(33.6%)。溢奶、过度哭闹、稀便、排便困难或大便干结的患病率分别为14.4%、1.7%、23.0%、8.5%。婴儿中存在单一溢奶者8.9%、单一过度哭闹0.7%、单一稀便10.3%、单一排便困难或大便干结7.9%;同时存在两种及以上问题的婴儿中,溢奶合并稀便症状所占比例最高,为4.3%。溢奶、过度哭闹和稀便问题的发生率随月龄增加逐渐减小(P值均<0.05),排便困难或大便干结的发生率随月龄增加而逐渐增高(P<0.05)。结论 婴儿存在较高比例的溢奶、稀便等问题,重点关注6月龄的婴儿及其抚养人。应对孕妇和新生儿父母开展有针对性地处理胃肠道常见相关问题的护理和喂养知识,发现问题能够早期给予婴儿进行筛查诊疗服务以及对家长安抚教育。
Abstract
Objective To study the situation of common gastrointestinal problems among 1~12 months infants in 15 Chinese cities,and to provide theoretical basis for early-stage prevention and intervention against infantile gastrointestinal common problems. Methods Totally fifteen cities were chosen according to China′s geological and demographic distribution. Randomly cluster sampling method was used to choose a community within each city as the sample region. Infants aged 1~2 months were enrolled and their caregivers were interviewed by face-to-face questionnaire survey. Results Of 4 202 recruited infants,1 411 infants (33.6%) had common gastrointestinal problems. The prevalence of regurgitation,excessive crying,loose stools,dyschezia or dry stools were 14.4%,1.7%,23.0% and 8.5%,respectively. The prevalence of single regurgitation,excessive crying,loose stools,dyschezia or dry stools in infants with common gastrointestinal problems were 8.9%,0.7%,10.3% and 7.9%,respectively. Among complicated symptoms,the one with the highest rate was regurgitation and loose stools (4.3%);The prevalence rate peaked among infants aged 1~6 months,and the prevalence rate of regurgitation,excessive crying and loose stools dropped sharply with the age increased (P<0.05) while the prevalence rate of dyschezia or dry stools increased(P<0.05). Conclusions Gastrointestinal common problems in Chinese infants is increasingly prevalent. It is suggested to give related health education on gastrointestinal problems and feeding,thereby signifying the importance of primary prevention and intervention for infants and caregivers.
关键词
胃肠道问题 /
功能性紊乱 /
婴儿
Key words
gastrointestinal symptoms /
functional disorder /
infants
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Tilburg MA,Hyman PE,Walker L,et al.Prevalence of functional gastrointestinal disorders in infants and toddlers[J].J Pediatr,2015,166(3):684-689.
[2] Ferreira-Maia AP,Matijasevich A,Wang YP.Epidemiology of functional gastrointestinal disorders in infants and toddlers: A systematic review[J].World J Gastroenterol,2016,22(28):6547-6552.
[3] Fujiwara T,Barr RG,Brant R,et al.Infant distress at five weeks of age and caregiver frustration[J].J Pediatr,2011,159(3):1-2.
[4] Benninga MA,Faure C,Hyman PE,et al.Childhood functional gastrointestinal disorders: neonate/toddler[J].Gastroenterology,2016,150(Suppl 1):1443-1455.
[5] Vandenplas Y,Gutierrez-Castrellon P,Velasco-Benitez C,et al.Practical algorithms for managing common gastrointestinal symptoms in infants[J].Nutrition,2013,29(1):184-194.
[6] 王惠珊,盛晓阳,许春娣,等.婴儿胃肠道常见问题筛查干预流程(一)-溢奶[J].临床儿科杂志,2015,33(1):95-96.
[7] 王惠珊,盛晓阳,许春娣,等.婴儿胃肠道常见问题筛查干预流程(二)-过度哭闹[J].临床儿科杂志,2015,33(2):199-200.
[8] 王惠珊,盛晓阳,许春娣,等.婴儿胃肠道常见问题筛查干预流程(三)-排便困难/大便干结[J].临床儿科杂志,2015,33(3):299-300.
[9] 王惠珊,盛晓阳,许春娣,等.婴儿胃肠道常见问题筛查干预流程(四)—稀便[J].临床儿科杂志,2015,33(4):399-400.
[10] Houghteling PD,Walker WA.Why is initial bacterial colonization of the intestine important to the infant′s and child′s health?[J].J Pediatri Gastroenterol Nutr,2015,60(3):294-307.
[11] Chogle A,Velasco-Benitez CA,Koppen IJ,et al.A population-based study on the epidemiology of functional gastrointestinal disorders in young children[J].J Pediatr,2016,179(95):139-143,e1.
[12] Lo Vecchio A,Vandenplas Y,Benninga M,et al.An international consensus report on a new algorithm for the management of infant diarrhoea[J].Acta Pediatr,2016,105(8):e384-e389.
[13] Hegar B,Dewanti NR,Kadim M,et al.Natural evolution of regurgitation in healthy infants[J].Acta Paediatr,2009,98(7):1189-1193.
[14] 刘伟,肖丽萍,李云,等.上海市闵行区婴幼儿轻度胃肠功能紊乱的流行病学调查[J].中华儿科杂志,2009,47(12):917-921.
[15] Vandenplas Y,Leluyer B,Cazaubiel M,et al.Double-blind comparative trial with 2 antiregurgitation formulae[J].J Pediatr Gastroenterol Nutri,2013,57(3):389-393.
[16] Howard CR,Lanphear N,Lanphear BP,et al.Parental responses to infant crying and colic: the effect on breastfeeding duration.[J].Breastfeed Med,2006,1(3):146-155.
[17] Iacovou M,Ralston RA,Muir J,et al.Dietary management of infantile colic: a systematic review[J].Matern Child Health,2012,16(6):1319-1331.
[18] Lasekan JB,Jacobs J,Reisinger KS,et al.Lactose-free milk protein-based infant formula: impact on growth and gastrointestinal tolerance in infants[J].Clini Pediatrics(Phila),2011,50(4):330-337.
[19] Freedman SB,Al-Harthy N,Thull-Freedman J.The crying infant: diagnostic testing and frequency of serious underlying disease[J].Pediatrics,2009,123(3):841-848.
[20] 李东阳,王争艳,朱雪娜,等.北京市城区婴儿养育现状调查及影响因素分析[J].中国儿童保健杂志,2015,23(6):619-623.
[21] Tunc VT,Camurdan AD,I·lhan MN,et al.Factors associated with defecation patterns in 0-24-month-old children[J].Eur J Pediatr,2008,167(12):1357-1362.
[22] Turco R,Miele E,Russo M,et al.Early-life factors associated with pediatric functional constipation[J].J Pediatr Gastroenterol Nutr,2014,58(3):307-312.
基金
中国疾病预防控制中心妇幼保健中心科研项目(2013FY003)
PDF(725 KB)
