儿童上消化道出血的趋势:幽门螺杆菌感染和使用非甾体抗炎药的影响

Felicia Galos, Mara Ioana Ionescu, Mihai Daniel Luca Mirea, Anca Andreea Boboc, Andreea Ioan, Catalin Boboc
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摘要

上消化道出血(UGIB)是儿童的一个重大问题,占儿科重症监护病房病例的 6-20%。本研究评估了幽门螺杆菌(H. pylori)感染和非甾体抗炎药(NSAID)使用在儿童上消化道出血病因中的作用,尤其关注 COVID-19 大流行期间观察到的趋势。我们对 2015 年 1 月至 2023 年 12 月间因 UGIB 而接受食管胃十二指肠镜 (EGD) 检查的 103 名儿童患者进行了回顾性分析。其中,88 名患者被纳入最终分析,并成功确定了出血来源。吐血是最常见的表现,85.43%的病例确定了出血源。幽门螺杆菌感染率在大流行前(39.7%)和大流行后(36.7%)期间保持稳定。然而,非甾体抗炎药的使用在大流行期间增加了近三倍,大流行后 36.7% 的 UGIB 病例与使用非甾体抗炎药有关,而大流行前仅为 12.1%。这些发现强调了幽门螺杆菌和非甾体抗炎药的使用在小儿 UGIB 中的重要作用,大流行期间非甾体抗炎药相关病例明显增加。
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Trends in Upper Gastrointestinal Bleeding in Children: The Impact of Helicobacter pylori Infection and Non-Steroidal Anti-Inflammatory Drug Use
Upper gastrointestinal bleeding (UGIB) is a significant concern in children, contributing to 6–20% of cases in pediatric intensive care units. This study evaluates the roles of Helicobacter pylori (H. pylori) infection and non-steroidal anti-inflammatory drug (NSAID) usage in the etiology of UGIB in children, with a particular focus on trends observed during the COVID-19 pandemic. We conducted a retrospective analysis of 103 pediatric patients who underwent esophagogastroduodenoscopy (EGD) for UGIB between January 2015 and December 2023. Of these, 88 patients were included in the final analysis, where the source of bleeding was successfully identified. Hematemesis was the most common presentation, and the source of bleeding was identified in 85.43% of cases. The prevalence of H. pylori infection remained stable across the pre-pandemic (39.7%) and post-pandemic (36.7%) periods. However, NSAID usage increased nearly threefold during the pandemic, with 36.7% of post-pandemic UGIB cases associated with NSAID use, compared to 12.1% pre-pandemic. These findings underscore the significant roles of H. pylori and NSAID use in pediatric UGIB, with a notable increase in NSAID-related cases during the pandemic.
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