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the general clinical characteristic of observable children.

For the decision of tasks in view we had been surveyed 205 children with a syndrome of a constipation at the age from 4 till 17 years (125 boys - 61 % and 80 girls - 39 %). Middle age of children has made 10,13,15 years.

Distribution of children with a constipation syndrome on age and a floor is presented in table 2.1.

Table 2.1 Distribution of children with a constipation syndrome on age and a floor (n=205)

Age IN TOTAL
4-6 7-11 12 also is more senior M D
M D M D M D
Number 18 10 78 44 30 25 126 79
% 8,8 4,9 38,1 21,5 14,6 12,2 61,5 38,5

Apparently from tab. 2.1 a constipation children of all age groups suffered, however more often others this pathology is defined at children at the age from 7 till 11 years. Thus at boys the constipation is diagnosed in 1,6 times more often, than for girls (p-.0.01).

In the course of inspection all observable children have been parted on 2 groups: 1st group - 66 children with an acute constipation (OZ) and the second group - 139 children with a chronic constipation (HZ).

Criteria of including of children in group with OZ:

1. Children suffering OZ at the age from 4 till 17 years;

2. Duration of disease less than 3 months;

3. OZ, not demanding surgical treatment;

4. Absence of an endocrine pathology, organic lesion TSNS, mental diseases;

5. Presence of the informed consent of parents and children is more senior 14 years.

Criteria of including of children in group with HZ:

1. Children suffering HZ at the age from 6 till 17 years;

2. Duration of disease more than 3 months;

3. Children with HZ which reason does not demand surgical treatment;

4. Absence of an endocrine pathology, organic lesion TSNS, mental diseases;

5. Presence of the informed consent of parents and children is more senior 14 years.

Distribution of children on age and a floor depending on character of a current of disease is presented in table 2.2.

Table 2.2 Distribution of children with an acute and chronic constipation on age and a floor (n=205).

Apparently from tab. 2.2 in our observation among children, both with acute, and with a chronic constipation patients at the age from 7 till 11 years (45,5 % and 66,2 %) prevailed. Thus at the age from 4 till 6 years OZ has been diagnosed for 34,8 % of children, and HZ - only at 3,6 % of children (p - 0.01).obratnaja the picture took place in age group from 12 years and is more senior, where OZ has been diagnosed for 19,7 % of children, and HZ - at 30,2 % of patients.

Thus, OZ authentically it is more often diagnosed for children of preschool age and is much more rare at the senior school age, that, as a rule, it is bound to psychosomatic features of children of this age group.

Interest represents the analysis of gender features of observable children depending on character of a current of disease (fig. 2.1, 2.2).

Fig. 2.1. Distribution of children with an acute constipation on age and a floor (n=66).

Fig. 2.2 Distribution of children with a chronic constipation on age and a floor (n=139).

Apparently on fig. 2.1, among children with OZ only at the age from 12 years also is more senior girls prevailed. In other age groups with OZ boys that took place and at all children with HZ irrespective of their age (rice 2.2) is more often suffered.

We had been carried out the analysis of the risk factors having essential value in formation of a constipation at observable children depending on character of a current.

As data of the anamnesis of a life have shown, major of risk factors were:


1. The burdened heredity on a pathology GASTROINTESTINAL TRACT, and first of all on colon diseases. According to the anamnesis of 62,1 % of parents of children with OZ and 49,6 % of parents of children with HZ had various diseases GASTROINTESTINAL TRACT. However parents of children with HZ suffered constipations (30,2 %) in comparison with family cases at children with OZ (24,2 %) is a little bit more often.

2. The burdened obstetric anamnesis (abortion threat, gestoz, labours by cesarean sections, a prematurity). At children with HZ the burdened obstetric anamnesis met in 2 times more often (38,8 %), than at children with OZ (18,2 %) (r-.0.01).

3. The analysis of character of feeding of observable children on the first year of a life has shown, that 84,9 % of children with OZ received thoracal feeding since a birth, and at 72 % from them duration of thoracal feeding has made more than 6 months. The quantity of children with HZ, were since a birth on thoracal feeding, did not differ from those with OZ and has made 84,2 %. However duration of thoracal feeding became perceptible more than 6 months only at 20,9 % of children with HZ, that is authentic less in comparison with children with OZ (p-.0.01).

4. Features of a food of children are more senior year (frequency rate and equation of a food, a drinking regimen, superfluous consumption of flour products and a disadvantage of consumption of sour-milk products, vegetables and fruit). Children with HZ authentically more often (r 0.01) did not observe a rational diet (51,8 %), in comparison with children with OZ (32,4 %).

5. The transferred diseases, including infectious. At 28,1 % of children with HZ at inspection parasitogenic diseases or the transferred intestinal infection in the anamnesis (an ascariasis - at 9,4 % of children, a lambliasis - at 5,8 % of children and an intestinal infection - at 13 % of children) have been taped. At
Patients with OZ at inspection almost in 2 times more often (43,4 %) became perceptible intestinal infections or parasitogenic diseases. Thus the ascariasis met a little bit less often (7,0 %), and the lambliasis and an intestinal infection more often (10,6 % and 25,8 %) in comparison with children with HZ, however the received differences were not statistically significant.

6. An accompanying somatic pathology. The analysis of an accompanying somatic pathology has shown, that children with HZ besides inflammatory and functional diseases of the top department of a digestive tube (VOPT) (70,5 %), had a pathology from a pancreas (85,6 %), biliarnoj systems (40,2 %), and also disturbances from vegetative nervous system (37,4 %), thus at 82 % of children the various combination of the specified pathologies became perceptible. While at children with OZ the accompanying pathology from digestion organs met in 2 times less often (34,8 %) (pO.01).odnako pathological changes biliarnoj system and a pancreas were taped with the same frequency, as at children with

HZ (40,1 % and 81,8 % accordingly). Attracted attention, that at the majority of children with OZ (84,8 %) and at half (46 %) patients with HZ took place disturbances of a microbiocenosis of an intestine. The burdened allergological anamnesis became perceptible in 2 times more often at children with OZ in comparison with children with HZ (21,2 % and 10,1 %).

7. The burdened neurologic status. Among children of survey samples at the neurologist on the first year of a life children with HZ (17,3 %), in comparison with children with OZ (12,1 %) were a little bit more often observed. After a year the quantity of children with HZ, observed at the neurologist, was enlarged in 3 times and became twice more in comparison with children with OZ (51,8 % and 27,3 %). Thus the greatest group among patients with HZ was made by children with a syndrome of vegetative dysfunction (37,4 %).

8. Psychosocial conditions of a family. The favorable psychological situation became perceptible only at half of children with HZ (51,8 %) while at OZ favorable psychosocial conditions in a family took place at the majority of children (78 %) p.0.01).takzhe at the anamnesis collecting the attention attracted, that the stress was the reason of a delay of a chair at 21,2 % of children with OZ and 33,8 % of children with HZ.

Thus, the comparative analysis of risk factors at observable children depending on character of a current of disease has shown, that in development OZ by the most significant are: disturbances of a microbiocenosis of the intestine which reason were infectious diseases and an antibioticotherapia (84,8 %), the transferred intestinal infections or presence of parasitogenic invasions (43,4 %); less often - the accompanying somatic anamnesis (34,8 %), an error in a diet (32,4 %), the hereditary factor (24,2 %), the burdened allergological anamnesis (21,2 %) and stressful situations (21,2 %). At children with HZ the most significant risk factors in disease development serve: Thoracal feeding less than 6 months (79,1 %), an accompanying somatic pathology GASTROINTESTINAL TRACT (70,5 %), diet non-observance (51,8 %), the burdened neurologic status (51,8 %), an adverse situation in a family (48,2 %), the burdened obstetric anamnesis (38,8 %), is more rare - stress (33,8 %), the burdened family anamnesis on colon pathologies (30,2 %) and the transferred intestinal infections (28,1 %).

2.2

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Scientific source IPATOV ANDREY ALEKSANDROVICH. EFFICIENCY of ACUPUNCTURE In COMPLEX TREATMENT of CHILDREN With the CONSTIPATION SYNDROME. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

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