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目的 回顾分析小儿胃食管返流 (GER) 4 2例 ,对该病的诊断与治疗进行讨论。方法 分析不同时间段的胃食管返流病例 4 2例 ,年龄 30天～ 5岁半 ,男 33例 ,女 9例。 35例合并食管裂孔疝 ,其中 3例合并胃排空延迟 ;2例为单纯胃排空延迟 ,无食管裂孔疝 ;1例出生后即有 GER症状 ,入院时因返流性食管炎引起食管下段狭窄。根据 4 2例的治疗过程和效果对不同的诊断和手术方法进行比较。结果 胃食管钡餐是诊断 GER首选的检查 ,结果可靠 ,尤其是连续观察效果会更佳。其它检查如同位素扫描、食管下段压力测定、 2 4小时食管 p H监测等都有一定作用。非手术治疗是首选的治疗方法 ,而各类手术中以 NISSEN胃底折叠术 +幽门成型术效果最佳。结论 小儿胃食管返流需区分生理性或病理性 ,诊断方法以钡餐为首选必要时辅以其它检查即能确诊 ,无解剖结构异常者首选非手术治疗 ,手术治疗中目前公认 NISSEN胃底折叠术 +幽门成型术是最好的术式
Objective To retrospectively analyze 42 children with gastroesophageal reflux disease (GER) and discuss the diagnosis and treatment of the disease. Methods Forty-two cases of gastroesophageal reflux disease were studied in different periods of time, ranging in age from 30 days to 5 years and a half. There were 33 males and 9 females. 35 cases with esophageal hiatal hernia, of which 3 cases with delayed gastric emptying; 2 cases of delayed gastric emptying, no hiatal hernia; 1 case of GER symptoms after birth, admission due to reflux esophagitis caused by lower esophageal narrow. According to 42 cases of the treatment process and the effect of different diagnostic and surgical methods were compared. The results of gastroesophageal barium meal is the first choice of diagnosis of GER examination, the results are reliable, especially for continuous observation will be better. Other tests such as isotope scanning, lower esophageal pressure measurement, 24 h esophageal p H monitoring have a role. Non-surgical treatment is the preferred treatment, and various types of surgery to NISSEN fundoplication + pyloroplasty best. Conclusion Gastroesophageal reflux should be differentiated between physiological and pathological. The diagnosis should be based on barium meal as the first choice. If necessary, it can be diagnosed with other tests. Non-anatomic abnormalities are the first choice for non-surgical treatment. Currently, NISSEN fundoplication Pylorus molding is the best surgical technique