Chronic abdominal pain in children
Chronic abdominal pain in children
复制标题
DOI：
10.1542/peds.2004-2523
复制
发表时间：
2005-03-01
期刊：
影响因子：
8
通讯作者：
Walker, LS
中科院分区：
文献类型：
--
作者：
Di Lorenzo, C;Colletti, RB;Walker, LS
慢性腹痛被定义为长期间歇性或持续性腹痛，是初级保健医生、内科专科医生和外科专家遇到的常见儿科问题。儿童慢性腹痛通常是功能性的，也就是说，没有客观证据表明存在潜在的器质性疾病。美国儿科学会和北美儿科胃肠病学、肝病学和营养学会慢性腹痛小组委员会在对医学文献进行全面、系统的回顾和评级的基础上编写了本报告。本报告附有基于文献综述和专家意见的临床报告。小组委员会审查了医学和心理病史、诊断测试以及药物和行为治疗的诊断和治疗价值。警报症状或体征（如体重减轻、胃肠道出血、持续发烧、慢性严重腹泻和严重呕吐）的存在与器质性疾病的患病率较高有关。没有足够的证据表明腹痛的性质或相关症状（如厌食、恶心、头痛和关节痛）的存在可以区分功能性和器质性疾病。尽管患有慢性腹痛的儿童及其父母更常感到焦虑或抑郁，但焦虑、抑郁、行为问题或最近的负面生活事件的存在并不能区分功能性腹痛和器质性腹痛。大多数因慢性腹痛而被带到初级保健医生办公室的儿童不太可能需要诊断测试。对治疗干预措施的儿科研究进行了检查，发现其有限或不确定。
Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists, and surgical specialists. Chronic abdominal pain in children is usually functional, that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion.The subcommittee examined the diagnostic and therapeutic value of a medical and psychological history, diagnostic tests, and pharmacologic and behavioral therapy. The presence of alarm symptoms or signs ( such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea, and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache, and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems, or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive.