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儿童便秘

最后审阅: 10 Nov 2024
最后更新: 09 Feb 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 排便困难或疼痛
  • 排便间的长间隔
  • 大便失禁
  • 少量、软便失禁
  • 腹部可触及粪块
  • 其他方面健康的儿童
完整详情

其他诊断因素

  • 腹痛
  • 腹胀
  • 肛裂
  • 相关的膀胱问题
  • 异常肛门外观
完整详情

危险因素

  • 低膳食纤维饮食
  • 食物营养摄入不足
  • 遗传易感性
  • 感染
  • 压力
  • 肥胖
  • 低出生体重
  • 精神病史
  • 身体残疾
  • 如厕训练不佳
  • 免疫失调
  • 液体摄入不足
  • 创伤
完整详情

诊断性检查

首要检查

  • 无初始检查
完整详情

需考虑的检查

  • 腹部 X 线检查
  • 不透射线标志物结肠通过试验
  • 腹部超声
  • 对比灌肠
  • 直肠抽吸活检
  • 心理评估
完整详情

新兴检查

  • 肛门直肠测压
  • 结肠测压

治疗流程

急症处理

无粪便嵌塞:<1 岁

无嵌塞:≥1 岁

有嵌塞:<1 岁

有嵌塞:1-3 岁

有嵌塞:≥4 岁

撰稿人

作者

Jaime Belkind-Gerson, MD, MSc

Director Neurogastroenterology and Motility Program

Digestive Health Institute

Children's Hospital Colorado

Associate Professor of Pediatrics

University of Colorado School of Medicine

Colorado

CO

利益声明

JB-G declares that he has no competing interests.

Claire Zar-Kessler, MD

Instructor in Pediatric Gastroenterology

Massachusetts General Hospital for Children

Boston

MA

利益声明

CZ-K has received support from Takeda for a clinical trial on prucalopride.

鸣谢

Dr Jaime Belkind-Gerson and Dr Claire Zar-Kessler would like to gratefully acknowledge Dr Corey Baker, Dr Wael El-Matary, Dr Steffen Reinsch, and Dr Meghan McPherson, the previous contributors to this topic.

利益声明

CB, WE-M, SR, and MM declare that they have no competing interests.

同行评议者

David C.A. Candy, MBBS, MSc, MD, FRCP, FRCPCH, FCU

Consultant Paediatric Gastroenterologist

Royal West Sussex NHS Trust

Chichester

UK

利益声明

DCAC has served as a consultant to, and spoken at symposia sponsored by, Norgine Ltd.

Vikram Boolchand, MD

Gastroenterology Fellow

University of Arizona

Tucson

AZ

利益声明

VB declares that he has no competing interests.

David J. Hackam, MD, PhD

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

PA

利益声明

DJH declares that he has no competing interests.

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