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Medix FTP Service (the "Service") is designed to provide you with an easy way to transfer files relevant to the management of your case to Medix Medical Services Europe Limited ("Medix", "we" and "us").

 

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首页经典案例抉择无法确认的痛苦– 渴望重获正常生活的小男孩

无法确认的痛苦– 渴望重获正常生活的小男孩

在R小朋友受到严重腹痛的折磨并接受大量测试后,几乎所有可能的诊断都验证过,但结果却都为正常。最后医生建议R的双亲带他见心理学家。到底R的不适是源自心理?或是有更深层的原因?

R是一名既好动又开朗的11岁小男孩,他十分受欢迎且为人理智,实现了各个卓越的童年里程碑。他们一家共有四名小孩,生活丰盛,充满爱、笑声与欢乐。他很少发脾气,可算是名全方位发展的小男孩,直至那突如期来的痛楚仿佛撕裂了他的小宇宙。

 

R在三年前开始出现没有任何明显诱引的痛楚。虽然痛楚是断断续续发生,但都有个共通点,就是由肚脐范围开始痛。每隔一至两个月痛楚就会出现,一般会持续3-7日并使他无法走动,因而导致他一整个学年缺席了40天课。随着这情况变得愈来愈难控制,他不只面临健康问题,连带学习进程都受到影响。

 

R的父母带他咨询普通科医生,可是多年来的各项检查和验血报告均无异常。而在影像中也没发现任何结石,因此医生开始怀疑会否与肠系膜淋巴结炎有关。肠系膜淋巴结炎是导致16岁以下小童腹痛的常见原因,具有腹部淋巴腺发炎特征。最终医生得出肠系膜腹部偏头痛这一诊断,它是一种常见于兒童的亚种偏头痛。其后医生处方了四种药物予他止痛,包括:补斯可胖糖(Buscopan)、扑热息痛(paracetamol)、布洛芬(ibuprofen)及制酸药(antacids),可是均对他的痛症毫无帮助,因此他的日常生活素质开始下降,更渐渐变得沉默寡言及内向。虽然R饮食习惯多样化,但他的痛楚并没有和任何食物种类有关,而过敏测试也没发现异常,医生只能判断他的健康正常。

 

R在2018年1月底因急性腹部剧痛入院,而这次更伴随着下背痛。医生最初以治疗尿道感染的方式处方抗生素,但期后撤回此决定。据他的儿科顾问医生指出,R的身体检查结果正常但却异常安静及情绪低落,因此R的家人被转介咨询儿童精神健康服务及痛症诊所。

 

为了找出儿子出现剧痛的原因,R的父母联系了Medix。 Medix安排了个人疗程管理团队予R,在得到他父母同意后,把他的检查报告传送给专家审核以获取一个综合性诊断。

 

R对蛋白、奶类、混合海鲜及小麦蛋白的过敏检测均为阴性,更测试了乳糜症(一种自身免疫系统疾病 - 小肠因麸质过敏而引致腹痛并难以消化食物和吸收重要营养),但结果同为阴性。腹部、肝、胰脏、脾、肾、胆囊及膀胱的进一步测试也没发现明显异常;葡萄糖指数和全血细胞指数也皆为正常。

 

Medix向儿科肠胃专家进行咨询,该名专家重新全面审视R的个案并认为R不需要再作其他检查,因为直到目时为止他已经做了很充足的检测。胃镜可以排除其他可疑诊断,但事实上在这个案中找出其他未发现的病原可能性已十分低。当乳糜症被排除后,非腹腔麸质过敏或乳糖不耐症可能就是引起他腹痛的原因。 Medix建议R向营养师咨询意见并测试是否有任何与饮食相关的肠胃道病因。

 

营养师安排了一个无麸质及奶类制品,但仍同时摄取足够钙质和均衡营养的餐单予R。自此之后他不再需要其他帮助就已解决腹痛问题。这个结果代表着R可能有非腹腔麸质过敏或乳糖不耐症,只要他持续遵循建议饮食计划就能避免出现突如期来的腹痛。

 

在多年的困惑和痛苦后,R终于能重过正常生活,他的健康与教育也不再成问题,父母也能放下心头大石。

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