目的 总结婴儿结肠镜检查的常见临床表现及病因，探讨相关疾病谱的变化。 方法 回顾性收集2015年1月—2024年12月于山东大学附属儿童医院消化科接受结肠镜检查的180例婴儿的临床资料，按检查年龄分为≤6月龄组（41例）和>6~12月龄组（139例），按检查时间分为2015—2019年组（83例）和2020—2024年组（97例）。分析结肠镜检查的主要原因、疾病诊断及疾病谱的变化。 结果 180例婴儿共行184例次结肠镜检查，主要原因依次为便血（37.8%，68/180）、腹泻（36.7%，66/180）及腹泻伴便血（21.1%，38/180）。≤6与>6~12月龄组结肠镜检查原因比较差异有统计学意义（P<0.05）。结肠息肉仅见于>6~12月龄组（P<0.05）。2020—2024年组食物过敏相关消化道疾病比例低于2015—2019年组，结肠炎比例高于2015—2019年组（P<0.05）。 结论 婴儿结肠镜检查对消化系统疾病的诊断具有重要价值，不同年龄及检查时间有其特定疾病谱。

Objective To investigate the underlying causes and clinical manifestations in infants undergoing colonoscopy, and to analyze changes in disease spectrum. Methods Clinical data from 180 infants who underwent a total of 184 colonoscopies at the Department of Gastroenterology, Children's Hospital Affiliated to Shandong University from January 2015 to December 2024 were retrospectively analyzed. Patients were grouped by age: ≤6 months (n=41) and >6-12 months (n=139); and by examination period: 2015-2019 (n=83) and 2020-2024 (n=97). Primary causes for performing colonoscopy, final diagnoses, and disease spectrum evolution were assessed. Results Among 184 colonoscopies, the leading causes prompting examination were hematochezia (37.8%, 68/180), diarrhea (36.7%, 66/180), and co-occurring hematochezia and diarrhea (21.1%, 38/180). Causes for performing colonoscopy differed significantly by age group (P<0.05). Colonic polyps were only detected in the >6-12 months group (P<0.05). Compared to the 2015-2019 group, the 2020-2024 group had fewer food allergy-related gastrointestinal diseases (P<0.05) but more colitis (P<0.05). Conclusions Colonoscopy is essential for diagnosing infantile digestive disorders, with disease spectra varying by age and time period.