目的:确定区分大麻素剧吐综合征(CHS)和循环呕吐综合征(CVS)的临床特征,两种以恶心发作为特征的情况,呕吐,和腹痛。
方法:我们对2015年至2022年入住大型儿童医疗保健系统的患者进行了回顾性图表回顾。使用ICD-9/10代码通过电子病历识别CHS和CVS患者。
结果:在筛选的201名患者中,125人包括在内。CHS患者年龄大于CVS患者(平均值[SD]18.06[1.41]vs.14.50[2.91]年,p<0.001)。性别差异不显著,种族,种族,或两组之间住院时间。CHS患者更有可能出现尿液药物筛查阳性(86%vs.2.9%,p<0.001),较低的平均(SD)血清钾(3.62[0.77]vs.3.88[0.49],p<0.001),和更高的平均(SD)血清肌酐(0.83(0.41)与0.63(0.17),p<0.001)。CHS患者的平均(SD)收缩压(SBP)明显较高(SBP124.46[10.66]vs.118.55[10.99],p=0.032)与年龄相当的CVS儿童相比。36%的患者获得了影像学检查,只有2.4%的患者出现异常。
结论:临床特征包括年龄较大,收缩压较高,尿液药物筛查阳性,选择电解质的发现可能会区分CHS和CVS。在这两种情况下的腹部成像是低产量的。这些发现可能有助于CHS患者的早期识别和适当的治疗。
OBJECTIVE: To identify clinical characteristics that distinguish cannabinoid hyperemesis syndrome (CHS) from cyclic vomiting syndrome (CVS), 2 conditions marked by episodes of nausea, vomiting, and abdominal pain.
METHODS: We performed a retrospective chart review of patients admitted to a large children\'s health care system from 2015 through 2022. Patients with CHS and CVS were identified by the electronic medical record using International Classification of Diseases, Ninth and Tenth Revision codes.
RESULTS: Of 201 patients screened, 125 were included. Patients with CHS were older than those with CVS (mean [SD] 18.06 [1.41] vs 14.50 [2.91] years, P < .001). There were no significant differences in sex, race, ethnicity, or hospital length of stay between groups. Patients with CHS were more likely to have a positive urine drug screen (86% vs 2.9%, P < .001), lower mean (SD) serum potassium (3.62 [0.77] vs 3.88 [0.49], P < .001), and greater mean (SD) serum creatinine (0.83 (0.41) vs 0.63 (0.17), P < .001). The average (SD) systolic blood pressure was significantly greater in patients with CHS (systolic blood pressure 124.46 [10.66] vs 118.55 [10.99], P = .032) compared with children of comparable age range with CVS. Imaging was obtained in 36% of all patients, and only 2.4% had abnormalities.
CONCLUSIONS: Clinical features including older age, greater systolic blood pressure, positive urine drug screen, and select electrolyte findings might distinguish CHS from CVS. Abdominal imaging in both conditions is of low yield. These findings may allow for early recognition and appropriate therapy in CHS patients.