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Colic |
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疝痛 |
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Colic is paroxysms of crying and irritability in an infant. Although the term colic suggests an intestinal origin, etiology is unknown. Colic often begins at about 6 wk and spontaneously improves between 3 and 4 mo. Paroxysms of crying and unhappiness develop at roughly the same time of day or night and continue for hours for no apparent reason. A few infants cry almost incessantly. Excessive crying may cause aerophagia, which results in flatulence and abdominal distention. Typically, the colicky infant eats and gains weight well, although vigorous non-nutritive sucking may suggest excessive hunger. Colic probably has no relation to development of an insistent, impatient personality. |
疝痛表現(xiàn)為嬰兒的陣發(fā)性哭鬧和煩躁不安。雖然疝痛一詞提示由腸道引起，但其病因并不清楚。疝痛常常始于6周大嬰兒，3－4個月時自行緩解。哭鬧和不快大致發(fā)生在白天或夜晚的同一時間并持續(xù)數(shù)小時，但并沒有明顯的原因。少數(shù)嬰兒幾乎會哭個不停。過度哭鬧會引起吞氣癥，導(dǎo)致氣脹和腹脹。一般說來，疝痛嬰兒飲食、體重增加良好，但強烈的與飲食無關(guān)的吮吸可能表明嬰兒過度饑餓。疝痛與迫切、急躁的人格發(fā)育可能沒有聯(lián)系。 | |
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Evaluation |
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評估 |
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History and physical examination: History should establish whether the infant's crying is outside the normal range (up to 3 h/day in a 6-wk-old infant). Then it must distinguish colic from other causes of excessive crying, including fever, UTI, ear infection, and maltreatment. Thorough questioning may reveal that crying is not the chief concern but a symptom that the parents have used to justify their visiting the physician to present another problem—eg, concern over the death of a previous child or over their feelings of inability to cope with a new infant. A thorough physical examination typically detects no abnormalities but reassures parents that the doctor understands how stressful a colicky infant can be for parents. |
病史與體格檢查：病史檢查包括嬰兒哭鬧是否超出正常范圍（6周大嬰兒每天哭鬧達3小時)。同時，應(yīng)將疝痛與因其他原因引起的過度哭鬧相區(qū)別，包括發(fā)燒、泌尿道感染、耳朵感染及受到虐待等。詳細詢問可能使你明白，哭鬧并不是主要問題，父母只是用以就診并向醫(yī)生提出其他問題而已，如父母對以前夭折的孩子的憂慮、擔心無法照顧好新的嬰兒等。詳盡的體格檢查一般不會發(fā)現(xiàn)什么異常情況，但它可以安慰病人，使他相信醫(yī)生理解疝痛嬰兒對家長所構(gòu)成的壓力。 | |
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Testing: No testing is necessary unless specific abnormalities are detected by history and examination.醫(yī)學(xué)全.在.線gydjdsj.org.cn |
檢驗：通常不需作檢驗，除非在病史和體檢中發(fā)現(xiàn)異常。 | |
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Treatment |
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治療 |
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Parents should be reassured that the infant is healthy, that his irritability is not due to poor parenting, and that colic will resolve on its own with no long-term adverse effects. The infant who cries for short periods may respond to being held, rocked, or patted gently. An infant with a strong sucking urge who fusses soon after a feeding may need to suck more. If a bottle feeding takes < 15 to 20 min, nipples with smaller holes should be tried; a pacifier also may quiet the infant. A very active, restless infant may respond, paradoxically, to being swaddled tightly. An infant swing, music, and white noise (eg, from a vacuum cleaner, car engine, or clothes or hair dryer) may also be calming. |
要使父母相信嬰兒是健康的，它的煩躁不安并不是因為父母照顧不周，疝痛可以自行解除，不會造成長期的不良后果。短時間哭鬧的嬰兒只要抱一抱、搖一搖或輕輕拍一拍就可以了。有強烈的吮吸欲、喂后不久就哭鬧的嬰兒可能需要更多的吮吸。如果一瓶奶15－20分鐘還不到就吸完了，就應(yīng)該償試用孔更小的奶嘴。橡皮奶嘴也可以安撫嬰兒。特別好動、不肯安靜的嬰兒用襁褓緊緊包裹就可以使他安靜下來。嬰兒秋千、音樂和白噪聲（如吸塵器、汽車發(fā)動機或衣服、頭發(fā)電吹風(fēng)所發(fā)出的聲音)也可以令他安靜下來。 | |
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A milk-substitute formula may be tried briefly to ascertain whether milk intolerance exists, but frequent formula switching should be avoided. Sometimes in breastfed infants, removal of milk or another food from the mother's diet brings relief. |
偶而用替代牛奶的配方奶可以確定嬰兒是否存在牛奶不耐受，但應(yīng)避免頻繁換用。有時，給母乳喂養(yǎng)的嬰兒停奶或換上另一種食物也可以減輕其哭鬧。 |
