ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG BỆNH VIÊM LOÉT DẠ DÀY TÁ TRÀNG Ở TRẺ EM ĐIỀU TRỊ TẠI BỆNH VIỆN SẢN-NHI TỈNH QUẢNG NGÃI

Abstract

Background: Peptic ulcer disease is the result of an inflammatory caused by an imbalance of cytoprotective and cytotoxic factors in the stomach and duodenum, leading to inflammation or peptic ulcer. Peptic ulcer disease in children is mainly chronic, H. pylori ^[1] is considered to be the primary cause. Today, gastroduodenal endoscopy is an invasive procedure, playing an important role in the diagnosis, treatment, and effective evaluation. In August 2019, Quang Ngai Hospital for Women and Children also carried out a gastroduodenal endoscopy for children admitted to the hospital with symptoms of peptic ulcer disease. There have been no studies to evaluate the benefits of gastrointestinal endoscopy in the diagnosis and treatment of peptic ulcers disease in children at this hospital. Objectives: 1. Describe clinical and subclinical characteristics of peptic ulcer disease in children treated at Quang Ngai Hospital for Women and Children. 2. Determine the relationship between clinical and subclinical characteristics of peptic ulcer in a child and H.pylori infection. Methods: A descriptive cross-sectional study was conducted on the pediatric age with peptic ulcers, with gastroduodenal endoscopy at Quang Ngai Hospital for Women and Children between April 2020 and September 2021. Results: Clinical and subclinical characteristics: The most cases, abdominal pain reaches 98.1%. Among abdominal locations, epigastric abdominal pain is 76.7%, gastrointestinal hemorrhage is 19.0%. Anemia accounts for 18.1%. Erythrocyte indices such as MCV, MCH, MCHC, RWD, Hb in children with peptic ulcer diagnosed anemia  are 81.0fL, 26.9pg, 31.9g/dl, 13.7% and 12.2%, respectively. The figure for gastritis is 73.3%. The rate of ulcers reaches 26.7%. Positive CLO-test accounts for 43.8% and the proportion of H. pylori infection is 32.4%. Relationship: There is a connection between age, sex, characteristics of abdominal pain, gastrointestinal hemorrhage, anemia, endoscopy result and H.Pylori infection result (p<0.05). Conclusions: Abdominal pain is (98.1%), anemia accounts for 31.5%, H.Pylori infection reaches 32.1%. There is a statistically significant relationship between age, sex, characteristics of abdominal pain, gastrointestinal hemorrhage, anemia, endoscopy result and H.Pylori infection result. The risk of H. pylori infection in children with ulcers is 14.6 times compared with the others. The rate of children infected with both gastrointestinal hemorrhage and H. pylori infection is 2.65 times compared to children with H. pylori and without gastrointestinal hemorrhage.