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　　小兒腹痛是兒科常見(jiàn)病癥，但是由于引起腹痛的原因較多，家長(zhǎng)在送孩子就診時(shí)要注意觀察孩子的癥狀，千萬(wàn)不要隨意給孩子使用止痛藥，否則就會(huì)掩蓋發(fā)病時(shí)的癥狀，影響醫(yī)生對(duì)病情的觀察，以致延誤診斷和治療。如果孩子出現(xiàn)下面這些常見(jiàn)的腹痛癥狀，家長(zhǎng)應(yīng)該及時(shí)做好相應(yīng)的處理，并且盡快送孩子去醫(yī)院就診。</p><p> 　　<strong>1. 蛔蟲(chóng)病</strong></p><p> 　　腹痛特點(diǎn)　　當(dāng)環(huán)境改變或孩子發(fā)燒、腹瀉、饑餓以及吃刺激性食物時(shí)突然腹痛，孩子哭叫打滾、屈體彎腰、出冷汗、面色蒼白，腹痛以肚臍周?chē)顬閲?yán)重。常伴有嘔吐，甚至可吐出蛔蟲(chóng)。有時(shí)腹痛能自行緩解甚至消失，孩子則顯得疲憊，等完全恢復(fù)后又可以照常玩耍。每次疼痛發(fā)作數(shù)分鐘，這種疼痛可能隔天發(fā)作，也可能每天發(fā)作數(shù)次。</p><p> 　　腹痛原因　　蛔蟲(chóng)的幼蟲(chóng)在小腸發(fā)育為成蟲(chóng)后，對(duì)小腸有毒性作用和機(jī)械刺激作用，使人發(fā)生腹痛、腹瀉、消化不良等癥狀。當(dāng)成蟲(chóng)的數(shù)目多達(dá)數(shù)十條或數(shù)百條時(shí)，蟲(chóng)體可以互相扭結(jié)成團(tuán)，引起腸梗阻。且蛔蟲(chóng)有鉆孔習(xí)性，常鉆入闌尾、膽道引起闌尾炎和膽道蛔蟲(chóng)癥，從而出現(xiàn)腹痛。</p><p> 　　<strong>2. 急性闌尾炎</strong></p><p> 　　腹痛特點(diǎn)　　開(kāi)始時(shí)孩子感覺(jué)胃疼或肚臍周?chē)?，?shù)小時(shí)后才轉(zhuǎn)為右下腹部疼痛。用手按小兒右下腹時(shí)會(huì)加劇孩子的哭鬧，孩子還常伴有惡心及嘔吐等癥狀，然后出現(xiàn)發(fā)燒，體溫可升高達(dá)39℃左右。</p><p> 　　腹痛一般不太劇烈，但孩子常常蜷曲著右腿臥床或彎著腰走路，如果孩子還不能用語(yǔ)言來(lái)表達(dá)疼痛的話，他的哭鬧也與平時(shí)不一樣，會(huì)蜷縮著身體，并且出冷汗?？摁[如果超過(guò)3小時(shí)以上，家長(zhǎng)應(yīng)懷疑是否有患闌尾炎的可能。　伴隨癥狀　　小兒各年齡均可以得急性闌尾炎，而且比較常見(jiàn)。除了腹痛，還會(huì)伴有以下癥狀：</p><p> 　　1、惡心、嘔吐：大多數(shù)孩子伴有嘔吐，嘔吐物多為未消化的食物。</p><p> 　　2、發(fā)燒：大多數(shù)患兒在腹痛出現(xiàn)后不久開(kāi)始發(fā)燒，也有表現(xiàn)為哭鬧與發(fā)燒同時(shí)出現(xiàn)。</p><p> 　　3、怕揉肚子：患兒怕家長(zhǎng)或醫(yī)生用力按壓右下腹，該處腹壁肌肉發(fā)緊，孩子拒絕大人揉按腹部。也有些患兒癥狀不典型，如有的患兒一開(kāi)始就腹瀉，很像腸炎。</p><p> 　<strong>　3. 嵌頓疝</strong></p><p> 　　腹痛特點(diǎn)　　孩子陣發(fā)性哭鬧、腹痛、腹脹和嘔吐，在站立或用力排便時(shí)腹股溝內(nèi)側(cè)出現(xiàn)一腫脹物，或僅表現(xiàn)為一側(cè)陰囊增大。經(jīng)醫(yī)生治療后，這種情況還可能反復(fù)發(fā)生。</p><p> 　　腹痛原因　　由于小兒哭泣、咳嗽、大笑、打噴嚏、用力(比如解大便時(shí))等原因引起腹壓增加，從而使腸子進(jìn)入腹股溝或陰囊進(jìn)而造成腹痛。小兒疝氣以臍疝和腹股溝疝為多見(jiàn)。臍疝發(fā)生嵌頓的機(jī)會(huì)很少，多數(shù)由于腹股溝疝發(fā)生嵌頓而造成腹痛。</p><p> 　　<strong>4. 小兒胃腸生長(zhǎng)痛</strong></p><p> 　　腹痛特點(diǎn)　　有些孩子會(huì)莫名其妙地發(fā)生陣發(fā)性腹痛，多方檢查又找不到原因，服治療腸痙攣和驅(qū)蟲(chóng)的藥也無(wú)效。其實(shí)，這種腹痛可能是一種正常的生理現(xiàn)象，醫(yī)學(xué)上稱(chēng)為“小兒胃腸生長(zhǎng)痛”。</p><p> 　　小兒胃腸生長(zhǎng)痛的主要特征是在一定時(shí)間內(nèi)反復(fù)發(fā)作，每次疼痛時(shí)間較短，一般不超過(guò)10分鐘。腹痛部位以腹周為主，其次是上腹部。時(shí)痛時(shí)止，反復(fù)發(fā)作，腹痛可輕可重，嚴(yán)重時(shí)可令孩子持久哭叫、翻滾，肚子稍硬，間歇時(shí)整個(gè)腹部柔軟，可伴有嘔吐，吐后精神尚好。　疼痛無(wú)一定規(guī)律性，疼痛程度也不一致，輕的僅為腹部不舒適感，重則為腸絞痛，孩子疼痛難忍，還可聽(tīng)到“咕嚕”的腸鳴音。但這種疼痛可很快緩解，緩解后孩子的精神狀態(tài)、飲食及活動(dòng)即恢復(fù)正常。</p><p> 　　腹痛原因　　小兒胃腸生長(zhǎng)痛是由于腸壁肌肉強(qiáng)烈收縮引起的陣發(fā)性腹痛，為小兒急性腹痛中最常見(jiàn)的情況。其發(fā)生的原因與多種因素有關(guān)，如受涼、暴食、大量冷食、嬰兒喂乳過(guò)多等等。這種腹痛多見(jiàn)于3～12歲<a href='http://wyyxscd8644.com/zixun/ertong/' target='_blank'><u>兒童</u></a>。其機(jī)理是由于孩子生長(zhǎng)發(fā)育快，機(jī)體的血液供給一時(shí)間相對(duì)不足，腸道在暫時(shí)缺血狀態(tài)下，出現(xiàn)痙攣性收縮引起疼痛。另外，由于自主神經(jīng)功能紊亂，會(huì)導(dǎo)致腸壁神經(jīng)興奮與抑制作用的不協(xié)調(diào)，引起腸管平滑肌強(qiáng)烈收縮也會(huì)出現(xiàn)疼痛，所以醫(yī)學(xué)上又稱(chēng)之為“小兒腸痙攣”。</p><p> 　<strong>　5. 細(xì)菌性痢疾</strong></p><p> 　　腹痛特點(diǎn)　　常起病急驟，先有發(fā)燒達(dá)39℃甚至更高，大便次數(shù)增多，腹瀉前常有陣發(fā)性腹痛，肚子里“咕嚕”聲增多，但腹脹不明顯。病兒脫水嚴(yán)重，皮膚彈性差，全身乏力。</p><p> 　　腹痛原因　　本病以夏秋兩季多發(fā)，主要是不注意飲食衛(wèi)生而引起細(xì)菌感染</p><p><strong>　　6. 過(guò)敏性紫癜</strong></p><p> 　　腹痛特點(diǎn)　　過(guò)敏性紫癜是一種變態(tài)反應(yīng)性疾病，都伴有周身的癥狀。首先表現(xiàn)為皮膚紫癜，面積大小不等，表面紫紅色，多分布于四肢和臀部，以踝、膝關(guān)節(jié)處明顯。在此基礎(chǔ)上出現(xiàn)腹部陣發(fā)性劇烈絞痛，以臍周或下腹部明顯，有壓痛，但肚子軟?？砂橛懈篂a及輕重不等的便血，大便為黑色或紅色。它是由于腸管內(nèi)壁出血、水腫造成的。有的小兒還伴有關(guān)節(jié)腫痛，甚至血尿等情況。</p><p> 　　<strong>7. 慢性胃炎</strong></p><p> 　　腹痛特點(diǎn)　　小兒慢性胃炎或消化性潰瘍常為反復(fù)陣發(fā)性腹痛，多無(wú)規(guī)律，以臍上及臍周痛為主，常同時(shí)伴有上腹部壓痛、厭食、消瘦、嘔吐、泛酸等典型表現(xiàn)。多數(shù)病兒有飲食不潔、饑飽不均或喜食生冷史。</p><p> 　<strong>　8. 習(xí)慣性腹痛</strong></p><p> 　　腹痛特點(diǎn)　　當(dāng)排除各種可能性的急性疾病和蛔蟲(chóng)病外，找不到病因的各種反復(fù)性腹痛都可能是習(xí)慣性腹痛。</p><p> 　　多半在4歲左右開(kāi)始。常在早餐或飯后痛，問(wèn)孩子哪個(gè)部位痛，常指肚臍部，沒(méi)有發(fā)燒或腹瀉。疼痛并不很厲害，過(guò)10～20分鐘就好了，好像什么事也沒(méi)有了?？墒堑诙旌⒆佑謺?huì)同樣地叫嚷肚子痛，到醫(yī)院檢查，找不到實(shí)質(zhì)性的病變，檢查大便也找不到蟲(chóng)卵。</p><p> 　　腹痛原因　　這種病雖然還沒(méi)有列入一般的教科書(shū)中，但在幼兒中是確實(shí)存在的，國(guó)外學(xué)者的研究還顯示，類(lèi)似這樣的腹痛不但存在，而且還相當(dāng)多。推測(cè)是因孩子的內(nèi)臟過(guò)于敏感，把胃腸的蠕動(dòng)誤當(dāng)作腹痛，也可能是由于便秘，因?yàn)橛泻芏嘈『⒃诖蟊愫?，腹痛便消失了?/p><p> 　　<strong>9. 急性腸系膜淋巴結(jié)炎</strong></p><p> 　　腹痛特點(diǎn)　　往往先有發(fā)熱、后有腹痛。腹絞痛的部位可能是彌漫的，或因發(fā)炎的淋巴結(jié)位置而有不同，但以右下腹最多見(jiàn)。腹痛部位易變，腹痛強(qiáng)度也易變。腹痛原因</p><p> 　　細(xì)菌通過(guò)胃腸道破裂的腸黏膜進(jìn)入乳糜管，使腸系膜淋巴結(jié)炎性增大;由于炎性滲出液刺激，出現(xiàn)發(fā)熱、腹痛、惡心、嘔吐、腹瀉等臨床癥狀。</p><p> 　<strong>　10. 腹型蕁麻疹</strong></p><p> 　　腹痛特點(diǎn)　　往往與孩子進(jìn)食魚(yú)、蝦、蛋類(lèi)等具有過(guò)敏原的食物有關(guān)，常在皮膚發(fā)生風(fēng)疹瘙癢的同時(shí)出現(xiàn)臍周痛，同時(shí)伴有嘔吐、腹瀉。</p><p> 　　腹痛原因　　大多發(fā)生于過(guò)敏體質(zhì)的孩子中。</p> </div> <div id="8hh5rq1ip" class="y_ju"></div> <div id="8hh5rq1ip" class="pnum"> <ul id="page_slice"> <div id="8hh5rq1ip" class="clear"></div> </ul> </div> <a href="/lhdoc/index.html?url=//wyyxscd8644.com/yuanyin/1054273.html" class="download_word download_word_lb" title="文檔下載" target="_blank"> <div id="8hh5rq1ip" class="download_card"> 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