Non-specific abdominal pain in childhood.
Non-specific abdominal pain in childhood.
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儿童时期非特异性腹痛。
DOI：
10.1136/archdischild-2015-309383
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发表时间：
2016
影响因子：
5.2
通讯作者：
Crawley E
中科院分区：
文献类型：
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作者：
Crawley E
尽管绝大多数病例是在初级保健或门诊机构中处理的，但非特异性腹痛 (NSAP) 是进入儿科医疗和外科病房的常见原因。 Thornton 等人的论文 1 旨在使用关联的英国医院发作统计数据来确定 12 年内随后发生器质性和功能性胃肠道疾病的相对风险。在此期间，有 268 623 名儿童因“腹部和骨盆疼痛”出院，但没有进一步说明。近 6% 的患者在 10 年内再次入院，要么是住院患者，要么是日间病例，并被诊断为器质性疾病。另外 5% 的患者在同一时期入院，并被贴上作者所描述的“功能障碍”的标签。作者确定了这项研究的一些优点和缺点，包括编码的准确性以及许多患有 NSAP 的儿童在初级或二级护理中得到诊断和治疗的事实。这意味着该结果仅适用于腹痛严重到需要入院的儿童组，不能普遍适用于儿科医生评估和治疗腹痛的大多数儿童。本研究讨论的主要器质性疾病是阑尾炎、炎症性肠病（IBD）和乳糜泻。就病例比例而言，急性阑尾炎被诊断得相对较早这一事实并不令人意外。应该指出的是，一小部分人发展为 IBD 已处于较晚的阶段（通常是 5 年之后）。因此，IBD 的诊断极不可能与几年前的 NSAP 有关，因为 NSAP 非常常见。此外，在研究期间，
Non-specific abdominal pain (NSAP) is a common reason for admission to paediatric medical and surgical units, although the vast majority of cases are managed in primary care or in an outpatient setting. The paper by Thornton et al 1 aims to determine the relative risk of subsequent organic and functional gastrointestinal disorders over a 12-year period using linked English Hospital Episodes statistics. During this period, 268 623 children were discharged from hospital with a code for ‘abdominal and pelvic pain’without further specification. Just under 6% were readmitted over a 10-year period as either inpatients or as day cases and a diagnosis of an organic condition was made. A further 5% were admitted during the same time period and given a label of what the authors describe as ‘a functional disorder’. The authors have identified some of the strengths and weaknesses of this study including the accuracy of coding and the fact that many children with NSAP are diagnosed and treated in primary or secondary care. This means that the results are only applicable to the group of children with abdominal pain severe enough to warrant an admission and are not generalisable to the majority of children assessed and treated by paediatricians for abdominal pain.The main organic conditions discussed in this study were appendicitis, inflammatory bowel disease (IBD) and coeliac disease. The fact that acute appendicitis was diagnosed relatively early on in the proportion of cases is not surprising. It should be noted that the small proportion who developed IBD was at a much later stage (often 5 years on). It is, therefore, highly unlikely that the diagnosis of IBD was related to the NSAP several years earlier as NSAP is so common. In addition, over the time period of the study,