Clinical Analysis Of 1250 Children With Liver Damage In A Hospital In Dali

Objective: To retrospectively analyze the clinical data of 1250 children who were hospitalized and diagnosed with liver damage in the First Affiliated Hospital of Dali University,so as to provide reference for improving the understanding of liver damage in children in our region and to avoid aggravation of the primary disease and further transformation to liver failure.Methods: A total of 1250 children who were hospitalized and diagnosed with liver damage at the First Affiliated Hospital of Dali University between January 01,2012 and December 31,2021 were collected and retrospectively analyzed by summarizing the data on their disease age,gender,ethnicity,living environment,clinical manifestations,auxiliary examinations,diagnosis and treatment effects,and drawing conclusions.Results:1.There were 1250 cases of children with liver damage in this study,722（57.76%）males and 528（42.24%）females;1047 cases（83.76%）were living in rural areas and 203（16.24%）in urban areas.All cases were from 23 ethnic groups,510 cases（40.80%）were Han Chinese,and the top five ethnic minorities were Bai,Yi,Lisu,Hui,and Naxi.There were 473cases（37.84%）in the age group of 29 days to 1 year,188 cases（15.04%）in the age group of1 to 3 years,183 cases（14.64%）in the age group of 3 to 7 years,and 406 cases（32.48%）in the age group of 7 to 14 years.2.In terms of the degree of liver damage,917 cases（73.36%）were mild,209 cases（16.72%）were moderate,and 124 cases（9.92%）were severe.The difference in the degree of liver damage between different age groups was statistically significant（p<0.05）,and the comparison between groups suggested that the degree of liver damage was heavier in the 29 days to 1 year old group than in the 3 to 7 years old group（p<0.008）;the difference in the degree of liver damage between different etiology groups was statistically significant（p<0.05）,and the comparison between groups suggested that the degree of liver damage was heavier in the unknown cause group than in the infected and non-infected groups（p<0.017）;the difference in the degree of liver damage between different ethnic groups was not statistically significant（p>0.05）.3.The difference between abnormal STB and GGT values and the degree of liver damage was statistically significant（p<0.05）,while the difference between abnormal ALB values and the degree of liver damage was not statistically significant（p>0.05）.4.In terms of the etiology of liver damage,infectious etiology accounted for 60.56%,and its composition ratio was ranked as follows: pneumonia,upper respiratory tract infection,infectious mononucleosis,scrub typhus,central nervous system infection,and infection of other sites;pathogens were detected in 234 cases among all children with pneumonia,and the top five in order of detection rate were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Mycoplasma pneumoniae,and Acid-producing Klebsiella.Non-infectious etiologies accounted for 35.04%,and their composition was ranked in the following order: trauma,immune diseases,genetic metabolic diseases,pharmacological liver damage,other diseases,mixed factors,poisoning from other causes,and structural abnormalities of the hepatobiliary tract.In addition unknown causes accounted for 4.40%.5.The differences in the distribution of etiology between different age groups were statistically significant（p<0.05）,and the comparison between groups suggested that the proportion of liver damage caused by infectious factors was higher in the 29 days to 1 year old group than in the 1 to 3 years old,3 to 7 years old,and 7 to 14 years old groups（p<0.008）,and the differences in the distribution of etiology between 1 to 3 years old and 3 to 7 and 7 to14 years old groups,and between 3 to 7 and 7 to 14 years old groups were not statistically significant（p>0.008）.There was no statistically significant difference in the distribution of causes of liver damage among different ethnic groups and living environments（p>0.05）.6.Only 17.60% of children with liver damage had clinical manifestations such as hepatosplenomegaly and jaundice;the difference between the presence or absence of clinical manifestations and the cause of liver damage was statistically significant（p<0.05）;the difference between the presence or absence of clinical manifestations and the degree of liver damage was not statistically significant（p>0.05）.7.In terms of the distribution of treatment effects,82.56% were effective,10.16% were effective,and 7.28% were ineffective;the difference in treatment effects between different etiologies was statistically significant（p<0.05）;the difference in treatment effects between different degrees of liver damage was not statistically significant（p>0.05）.Conclusion:1.Most children with liver damage were from rural areas,more males than females,and most common in the age group of 29 days to 1 year.The degree of liver damage was mostly mild,with more severe liver damage suggested by abnormal GGT and STB.2.The most common cause of liver damage was infection,which had the highest percentage in the 29 days to 1 year old group.The top two non-infectious factors are trauma and immune diseases,but other causes of liver damage should not be ignored.The degree of liver damage caused by unknown causes is more serious,and it is especially critical to actively identify the cause.3.Among children with specific clinical manifestations of liver damage,non-infectious and unknown causes account for a higher proportion;the outcome is better for liver damage due to non-infectious factors.