Colic

疝痛

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.

疝痛表现为婴儿的阵发性哭闹和烦躁不安。虽然疝痛一词提示由肠道引起，但其病因并不清楚。疝痛常常始于6周大婴儿，3－4个月时自行缓解。哭闹和不快大致发生在白天或夜晚的同一时间并持续数小时，但并没有明显的原因。少数婴儿几乎会哭个不停。过度哭闹会引起吞气症，导致气胀和腹胀。一般说来，疝痛婴儿饮食、体重增加良好，但强烈的与饮食无关的吮吸可能表明婴儿过度饥饿。疝痛与迫切、急躁的人格发育可能没有联系。

Evaluation

评估

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.

病史与体格检查：病史检查包括婴儿哭闹是否超出正常范围（6周大婴儿每天哭闹达3小时)。同时，应将疝痛与因其他原因引起的过度哭闹相区别，包括发烧、泌尿道感染、耳朵感染及受到虐待等。详细询问可能使你明白，哭闹并不是主要问题，父母只是用以就诊并向医生提出其他问题而已，如父母对以前夭折的孩子的忧虑、担心无法照顾好新的婴儿等。详尽的体格检查一般不会发现什么异常情况，但它可以安慰病人，使他相信医生理解疝痛婴儿对家长所构成的压力。

Testing: No testing is necessary unless specific abnormalities are detected by history and examination.医学全.在.线www.med126.com

检验：通常不需作检验，除非在病史和体检中发现异常。

Treatment

治疗

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.

要使父母相信婴儿是健康的，它的烦躁不安并不是因为父母照顾不周，疝痛可以自行解除，不会造成长期的不良后果。短时间哭闹的婴儿只要抱一抱、摇一摇或轻轻拍一拍就可以了。有强烈的吮吸欲、喂后不久就哭闹的婴儿可能需要更多的吮吸。如果一瓶奶15－20分钟还不到就吸完了，就应该偿试用孔更小的奶嘴。橡皮奶嘴也可以安抚婴儿。特别好动、不肯安静的婴儿用襁褓紧紧包裹就可以使他安静下来。婴儿秋千、音乐和白噪声（如吸尘器、汽车发动机或衣服、头发电吹风所发出的声音)也可以令他安静下来。

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确定婴儿是否存在牛奶不耐受，但应避免频繁换用。有时，给母乳喂养的婴儿停奶或换上另一种食物也可以减轻其哭闹。