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目的:探究奥美拉唑联合多潘立酮治疗小儿胃食管反流病的临床疗效。方法:选择2012年10月~2015年12月期间内因胃食管反流病入院接受治疗的患儿80例,所有患儿均采用奥美拉唑和多潘立酮联合治疗。在治疗前和治疗后8周内,观察患者的临床治疗效果、24 h食管下段p H值监测、电子胃镜检查和内镜下黏膜活检。结果:研究对象用药前后呕吐、恶心、反酸、上腹痛、烧心、胸骨后痛、咳嗽、气喘等八项临床症状得到了明显的改善,甚至消失,差异具有统计学意义(P<0.05);患儿治疗后的反流次数、反流时间≥5 min的次数、最长反流时间、总PH<4时间占总时间的百分比以及综合评分均较治疗前明显降低,差异具有统计学意义(t=33.385、40.862、47.710、21.806、53.508,P<0.05);与治疗前对比,研究对象治疗后有1例存在重度反流性食管炎未能恢复,28例存在不同程度改善,43例完全恢复,差异有统计学意义(Z=37.775,P<0.05);不良反应出现5例(3例轻微腹泻、2例轻微腹痛),发生率为6.25%。结论:奥美拉唑联合多潘立酮治疗小儿胃食管反流病的临床效果较为显著,能够明显改善小儿胃食管反流症状,安全性较高,值得在临床上进一步推广使用。
Objective: To investigate the clinical efficacy of omeprazole combined with domperidone in the treatment of children with gastroesophageal reflux disease. Methods: Eighty children admitted to hospital for gastroesophageal reflux disease from October 2012 to December 2015 were enrolled. All the patients were treated with omeprazole and domperidone. Before treatment and within 8 weeks after treatment, the patients were observed for clinical treatment, 24 h lower esophageal p H value monitoring, electronic gastroscopy and endoscopic mucosal biopsy. Results: Eight clinical symptoms such as vomiting, nausea, acid reflux, upper abdominal pain, heartburn, post - sternum pain, cough and asthma were significantly improved or even disappeared before and after treatment. The difference was statistically significant (P <0.05). The number of reflux after treatment, the number of reflux time ≥ 5 min, the longest reflux time, the percentage of total PH <4 time and the total score were significantly lower than before treatment, the difference was statistically significant ( t = 33.385,40.862,47.710,21.806,53.508, P <0.05). Compared with those before treatment, one case of severe reflux esophagitis after treatment failed to recover, 28 cases improved in varying degrees and 43 cases were complete (Z = 37.775, P <0.05). There were 5 adverse reactions (3 mild diarrhea and 2 mild abdominal pain) with a rate of 6.25%. Conclusion: Omeprazole combined with domperidone in the treatment of children with gastroesophageal reflux disease has a significant clinical effect, can significantly improve children with gastroesophageal reflux symptoms, high safety, it is worth further promotion in clinical use.