在初级保健中患有慢性胃肠道症状的儿童患有刺激性肠综合征
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Esmee M Hogervorst1, Ilse N Ganzevoort1, Marjolein Y Berger1
1Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Family practice
|July 1, 2023
概括
在初级保健中患有刺激性肠综合征 (IBS) 的儿童与没有IBS的儿童相比,出现了更糟糕的症状和生活质量. 区分IBS对于儿童功能性胃肠道疾病的适当治疗和预后至关重要.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 功能性胃肠道疾病 功能性胃肠道疾病
- 主要护理 儿科 儿科
背景情况:
- 刺激性肠综合征 (IBS) 是儿童常见的功能性胃肠疾病.
- 儿科IBS和其他初级保健诊断子组之间的预后差异尚未得到充分理解.
- 这项研究解决了在患有慢性胃肠道问题的儿童中描述症状轨迹和与健康相关的生活质量 (HRQoL) 的需要.
研究的目的:
- 描述慢性胃肠道症状儿童的症状过程和HRQoL,比较符合IBS罗马标准的儿童与不符合罗马标准的儿童.
- 将全科医生的诊断准确度与儿童IBS的罗马标准进行比较.
- 突出基于IBS诊断在初级保健中的预后和管理的潜在差异.
主要方法:
- 前性队列研究,随访期为1年.
- 在初级保健中包括患有慢性腹和/或腹痛的4-18岁儿童.
- 使用罗马III问卷,儿童健康问卷和特定症状的问卷来收集数据.
主要成果:
- 57.7%的儿童在基线达到IBS的罗马标准.
- 患有IBS的儿童显示,二级护理的转诊次数增加,更高的药使用率,以及在一年内患慢性腹和身体HRQoL降低的可能性更高.
- 在只有10%的病例中,全科医生诊断符合IBS的罗马标准,其中"便秘"是最常见的替代诊断.
结论:
- 在初级保健机构中,有与没有IBS儿童之间的症状进展和HRQoL存在显著差异.
- 这些发现强调了在儿科功能性胃肠道疾病中区分IBS和其他诊断的重要性.
- 需要进一步的研究来完善和验证IBS诊断的标准在不同的医疗机构.
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