《儿科学》课程教学课件（PPT讲稿）21 Chronic Gastritis in Children

ChronicGastritisinChildren

C h r o n i c G a s t r i t i s i n C h i l d r e n

IntroductionChronicgastritisis achronic inflammation口ofthegastricmucosacausedbylong-termorrepeatedharmfulfactorsChronicgastritisisa commondiseaseofthe upperdigestivetractinchildhoodThe maindiagnosic methodare口gastroscopyandpathologicalexamination

I n t r o d u c t i o n □ C h r o n i c g a s t r i t i s i s a c h r o n i c i n f l a m m a t i o n o f t h e g a s t r i c m u c o s a c a u s e d b y l o n g - t e r m o r r e p e a t e d h a r m f u l f a c t o r s C h r o n i c g a s t r i t i s i s a c o m m o n d i s e a s e of t h e u p p e r d i g e s t i v e t r a c t i n c h i l d h o o d □ T h e m a i n d i a g n o s i c m e t h o d a r e g a s t r o s c o p y a n d p a t h o l o g i c a l e x a m i n a t i o n

Classificationl.Chronic superficialgastritis(CSG):90-95%口2.Chronic atrophicgastritis

C l a s s i f i c a t i o n 1 . C h r o n i c s u p e r fi c i a l g a s t r i t i s ( C S G ) : □ 9 0 - 95% 2 . C h r o n i c a t r o p h i c g a s t r i t i s

Etiology1.InfectionofHelicobacterPylori(HP)2.Bilereflux3.Badeatinghabitsorimproperdiet4.AdversereactionofmedicineNon-steroidal anti-inflammatorydrugs NSAIDs口Cortisone,etc厦5.Othersneuropsychiatricfactors口Stress,fatigue oroverworkchronic diseases医genetic factos国

E t i o l o g y 1 . In f e c t i o n of H e l i c o b a c t e r P yl ori ( H P ) 2. Bile r e f l u x 3 . B a d e a t i n g h a b i t s o r i m p r o p e r d i e t 4 . A d v e r s e r e a c t i o n of m e d i c i n e □ N o n - s t e r o i d a l a n t i- i n f l a m m a t o r y d r u g s N S AI D s □ C o r t is o n e , e t c 5 . O t h e r s □ n e u r o p s y c h i a t r i c f a c t o r s □ S t r e s s , f a t i g u e o r o v e r w o r k □ c h r o n ic d i s e a s e s □ g e n e t i c f a c t o s

HelicobacterPylori(HP)

H e l i c o b a c t e r P y l o r i ( H P )

Etiology1.InfectionofHelicobacterPylori(HP)2.Bile reflux3.Badeatinghabitsorimproperdiet4.AdversereactionofmedicineNon-steroidal anti-inflammatorydrugs(NSAiDs)口Cortisone,etc口5.OthersneuropsychiatricfactorsStress,fatigue oroverworkchronic diseasesDgenetic factos口

E t i o l o g y 1 . In f e c t i o n of H e l i c o b a c t e r P yl ori ( H P ) 2. Bile r e f l u x 3 . B a d e a t i n g h a b i t s o r i m p r o p e r d i e t 4 . A d v e r s e r e a c t i o n of m e d i c i n e □ N o n - s t e r o i d a l a n t i- i n f l a m m a t o r y d r u g s ( N S A I D s ) □ C o r t is o n e , e t c 5 . O t h e r s □ n e u r o p s y c h i a t r i c f a c t o r s □ S t r e s s , f a t i g u e o r o v e r w o r k □ c h r o n ic d i s e a s e s □ g e n e t i c f a c t o s

ClinicalmanifestationsThe severity is varying.The courseisvaryingl.Recurrent abdominalpain:recurrentlack ofregularityintensityThe younger thechildren,the lesslocation:typical of abdominalpain the relationship with diet2.Other dyspepsia symptoms3.Growthstunted:4.Upper gastrointestinal bleeding:

T h e s e v e r i t y i s v a r yi n g. T h e c o u r s e i s v a r yi n g 1 . R e c u r r e n t a b d o m i n a l p a in： □ r e c u r r e n t □ l ack of r e gu l a r i t y □ i n t e n s i t y □ l oca t i o n: □ t h e r e l a t i o n s h i p w i t h d i e t 2 . O t h e r d y s p e p s i a s y m p t o m s 3 . G r o w t h s t u n t e d ： 4 . U p p e r g a s t r o i n t e s t i n a l b le e d in g ： Clinical m a n i f e s t a t i o n s The younger the children, the les s typical of abdominal pain

Auxiliaryexamination1.Gastroscope:the first choice forexaminationthe basis ofdiagnosis口2.PathologicalexaminationofgastricmucosaChronic superficialgastritis(CSG)口Chronicatrophic gastritis口3.BariummealX-rayexamination4.Bacteriological examinationforHPinfectionbacterial culture口tissue section stainingHpurease口丽rapid ureasetestNH4++CO213C-urea breathtesturea国examinationofserumAntibodyagainstHP

1 . G a s t r o s c o p e： □ t h e f ir s t c h o ic e f o r e x a m i n a t i o n □ t h e b a s i s o f d i a g n o s i s 2 . P a t h o l o g i c a l e x a m i n a t i o n o f g a s t r i c m u c o s a □ C h r o n ic s u p e r f ic ia l ga s t r it is ( C S G) □ C h r o n ic a t r o p h i c ga s t r it i s 3 . B a r i u m m e a l X-r a y e x a m i n a t i o n 4 . B a c t e r io l o g i c a l e x a m i n a t i o n fo r H P in fe c t i o n Hp u r e a s e u r e a N H 4 + + C O2 □ b a c t e r ia l c u lt u r e □ t i s s u e s e c t io n s t a in in g □ r a p id u r e a s e t e s t □ 1 3 C - u r e a b r e a t h t e s t e x a m i n a t i o n o f s e r u m A n t ib o d y a g a i n s t H P A uxi li a r y e x a m i n a t i o n

Normalgastric mucosa

N o r m a l ga st r i c m u c o s a