摘要
目的 调查包头市3-7岁儿童功能性便秘（Function Constipation, FC）的相关危险因素。方法采用基于罗马IV诊断标准自制的FC相关因素调查问卷表进行调查，2022年10月-2023年11月就诊于包头医学院第一附属医院就诊的FC患儿设为观察组，另将同期本院健康体检的健康儿童设为对照组。对两组儿童的临床资料进行分析，了解FC患儿的现状，并分析探讨FC的相关危险因素。结果 本次调查共发放问卷850份，有效的问卷数共778份，有效率为91.3%，FC组258例（33.16%），健康儿童组520例（66.84%）。所有样本儿童年龄均在3~7岁，其中男童355名（46.63%），女童423名（53.37%）。问卷收集可能导致FC的影响因素，并进行单因素分析及多因素Logistic回归分析，结果显示两组儿童不同年龄差异有统计学意义（P＜0.05），不同性别、不同民族比较差异无统计学义（P＞0.05）；过敏情况、便秘家族史、膳食模式、晚上是否喝牛奶、挑食情况、故意憋便情况是儿童功能性便秘的危险因素（OR值分别为2.618、7.720、2.028、2.222、3.125、35.603，P＜0.05）。结论 本文所研究包头市内3-7岁FC患儿发病机制与过敏情况、便秘家族史、膳食模式、故意憋便等多种危险因素密切相关，可以从其危险因素入手，进行及时干预，从而达到预防和治疗功能性便秘的目的。
关键词： 功能性便秘；儿童；危险因素；问卷调查
Abstract
Objective To investigate the risk factors related to Function Constipation (FC) in children aged 3-7 years in Baotou. Methods The FC related factors questionnaire made by ourselves based on the Rome IV diagnostic criteria was used to investigate. Children with FC who were admitted to the First Affiliated Hospital of Baotou Medical College from October 2022 to November 2023 were selected as the observation group, and healthy children who underwent physical examination in our hospital during the same period were selected as the control group. The clinical data of the two groups of children were analyzed to understand the status quo of children with FC, and the related risk factors of FC were analyzed and discussed. Results A total of 850 questionnaires were sent out in this survey, and 778 were effective, the effective rate was 91.3%, 258 cases (33.16%) in FC group and 520 cases (66.84%) in healthy children group. All the children in the sample were aged from 3 to 7 years, including 355 boys (46.63%) and 423 girls (53.37%). The factors that may lead to FC were collected by questionnaires, and univariate analysis and multivariate Logistic regression analysis were performed. The results showed that there was statistical significance between the two groups of children in different ages (P < 0.05), but there was no statistical significance between different genders and different nationalities (P > 0.05). Allergy, family history of constipation, dietary pattern, drinking milk at night, picky eating, and deliberate holding of bowels were the risk factors for functional constipation in children (OR values were 2.618, 7.720, 2.028, 2.222, 3.125, 35.603, P < 0.05). Conclusion The pathogenesis of FC children aged 3-7 years in Baotou city studied in this paper is closely related to multiple risk factors such as allergy, family history of constipation, dietary pattern, intentional constipation, etc. Timely intervention can be started from the risk factors, so as to achieve the purpose of prevention and treatment of functional constipation.
Key words： Functional constipation; Children; Risk factors; Questionnaire survey
参考文献 References
[1] FLEMMING G.Chronic functional constipation in infants and children[J]. Handbook of Experimental Pharmacology, 2020,261(2):377-396.
[2] 陈凌华,雷玲,李杰,等.南充地区 0～4 岁婴幼儿功能性便秘发病率及相关因素调查[J].中国妇幼保健,2019, 34(13):3060-3063.
[3] RAJINDRAJITH S, DEVANARAYANA N M, ADHIKARI C, et al. Constipation in children:an epidemio -logical study in Sri Lanka using Rome Ⅲ criteria[J]. Archives of Disease in Childhood,2012,197(8): 43-45.
[4] 高永祥,张晋昕.Logistic 回归分析的样本量确定[J].循证医学,2018,18(2):122-124.
[5] MARC A B,SAMUEL N,CHRISTOPHE F,et al.儿童功能性胃肠病罗马Ⅳ标准[J].中华儿科杂志,2017,55(1):4-14.
[6] 李唐,黄俊杰,尚磊,等.西安市0~4岁儿童功能性便秘患病特征及危险因素分析[J].中华儿科杂志,2022,60(7): 647 -654.
[7] 曾银珍,代东伶.儿童功能性便秘发病原因、机制和治疗研究现状[J].大医生, 2023, 8(21):137-141.
[8] 徐丽琴,顾君娣,温晋峰,等.学龄前儿童功能性胃肠病与饮食习惯的相关性研究[J].中国妇幼保健,2020,35(24): 4770-4773.
[9] 张树成,白玉作. 儿童便秘的治疗手段及应用指征[J].临床小儿外科杂志,2020,19 (1):12-17.
[10] 方虹霁,韩明慧,王园平,等.上海市长宁区学龄儿童消化不良症状发生情况及其与膳食模式的关联研究[J].复旦学报(医学版),2021,48(5):697-702.
[11] 胡静,闫坤龙,金玉.儿童功能性便秘危险因素与生活质量分析[J].江苏医药,2016,42(6):642-645.
[12] Chan MF，Chan YL. Investigating factors associated with functional constipation of primary school children in Hong Kong [J].Clin Nurs,2010,19(23):3390-3400.
[13] 胡根彪,尹燕,王红丽.婴幼儿功能性便秘肠道菌群特征及影响因素Logistic 回归分析[J].中国现代医生,2019, 57(16):54-57.
[14] 杨若言,吴利利,吴阿莉,等.肠道菌群与肥胖关系的研究进展[J].中国微生态学杂志,2019,31(8):969-975.
[15] 赵倩义,豆子莹,张骁.双歧杆菌四联活菌片联合乳果糖对儿童功能性便秘患者排便频次及肠道菌群的影响[J].中国微生态学杂志,2023,35(10):1173-1177.
[16] Shi Y, Chen Q, Huang Y, et al. Function and clinical implications of short-chain fatty acids in patients with mixed refractory constipation.[J] Colorectal Disease, 2016,18(8):803-810.
[17] 郭淼婕,刘晓萌,牟春笋.儿童功能性便秘相关危险因素分析[J].天津中医药大学学报,2021,40(2):200-204.
[18] 刘志勇,杨关根,杨琴燕,等.杭州地区结肠慢转运型便秘患儿遗传流行病学调查[J].中国中西医结合消化杂志, 2012, 20(9):398-401.
[19] 张琪.儿童功能性便秘及其主要证候类型的危险因素分析[D]. 天津中医药大学, 2020.
[20] 唐婷,朱江,郭敏,等.孤独症谱系障碍儿童便秘及睡眠问题与情绪行为问题的关系[J].重庆医科大学学报,2020, 45(1): 85-89.
[21] 甘盛兴.儿童精神心理因素与功能性消化不良的关系及治疗[J].世界最新医学信息文摘,2019,19(17):293-296.