论文部分内容阅读
为了解２４小时食管ｐＨ值监测在小儿胃食管返流（ＧＥＲ）诊治中的作用，研究小儿病理性ＧＥＲ的特点及其诊断标准，对５０例经钡餐造影诊为ＧＥＲ的患儿进行动态２４小时食管内ｐＨ值监测，３０例健康小儿为对照组，复查１３例病理性ＧＥＲ患儿治疗后（９例为手术治疗）的食管ｐＨ值。结果表明，ＧＥＲ组各项返流指标显著高于对照组。对照组中１例为病理性ＧＥＲ，ＧＥＲ组３１例为病理性，另１９例则为生理性。１３例食管裂孔疝（ＨＨ）患儿均有明显的病理性返流，其各项返流指标除ｐＨ值＜４次数外均显著高于单纯病理性ＧＥＲ；ＨＨ组卧位时返流≥５分钟次数、最长返流时间、总ｐＨ值＜４的时间占总观察时间的百分比和平均返流周期均显著大于立位时；单纯病理性ＧＥＲ组卧位时返流≥５分钟次数、最长返流时间和平均返流周期显著大于立位时，而返流次数则小于立位时。提示小儿病理性ＧＥＲ以卧位时明显，伴有食管裂孔疝者返流更为严重。动态２４小时食管内ｐＨ值监测可用于小儿ＧＥＲ的诊断、分析和疗效评定。
In order to understand the role of 24-hour esophageal pH monitoring in the diagnosis and treatment of gastroesophageal reflux disease (GER) in children and to investigate the characteristics and diagnostic criteria of pediatric pathological GER, 50 patients with GER diagnosed by barium meal were given dynamic 24-hour Esophageal pH value was monitored in 30 healthy children, and the esophageal pH values of 13 cases with pathological GER were retrospectively reviewed (9 cases were treated surgically). The results showed that the reflux index of GER group was significantly higher than that of control group. One case of pathological GER in the control group, 31 cases of pathological GER group, the other 19 cases were physiological. Thirteen patients with hiatal hernia (HH) had obvious pathological reflux, and the indexes of reflux were significantly higher than pure pathological GER except pH <4, while reflux in HH was ≥5 The number of minutes, the longest reflux time, the total pH value <4 the time of the total observation time and the average reflux time were significantly greater than the stand; pure pathological GER group when the position of reflux ≥ 5 minutes, the most The long-term regurgitation time and average regurgitant cycle are significantly greater than the stand-up time, while the number of regurgitant times is less than the stand-up time. Tip pediatric pathological GER obvious when lying position, accompanied by esophageal hiatal hernia reflux is more serious. Dynamic 24-hour esophageal pH monitoring can be used for the diagnosis, analysis and curative effect of pediatric GER.