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目的:动态监测小儿十二指肠胃返流与碱性胃食管返流的 pH 变化特点,研究返流发生的病理生理意义。方法:对68例病理性胃食管返流小儿及39例正常小儿进行胃食管双 pH24小时动态监测,观察小儿在进餐及胃排空后以及不同体位下胃食管 pH 值的变化特点。结果:对照组中19例(48.7%)监测到十二指肠胃返流,以立位及进餐后发生为主,持续时间短暂。病理性胃食管返流者中22例(32.4%)监测到十二指肠胃返流及碱性胃食管返流,以空腹及卧位时发生为主,持续时间及 pH 值碱化强度显著高于对照组。结论:进餐后短暂的十二指肠胃返流可能为生理现象;在十二指肠胃返流基础上发生的碱性胃食管返流是小儿胃食管返流的主要类型之一;空腹及卧位时的胃食管双 pH 监测在诊断病理性返流中价值更大。
OBJECTIVE: To dynamically monitor the pH changes of duodenal reflux and alkaline reflux in children and to study the pathophysiological significance of reflux. Methods: Sixty-four children with pathologic gastroesophageal reflux disease and 39 normal children were monitored for gastro-oesophageal pH24 hour dynamic changes. The changes of gastroesophageal changes in children after meal and gastric emptying and at different positions were observed. Results: In the control group, duodenal reflux was detected in 19 patients (48.7%), mainly in standing position and postprandial period, with short duration. Twenty-two patients (32.4%) with pathological gastroesophageal reflux showed duodenal reflux and alkaline gastroesophageal reflux, which occurred mainly in fasting and supine position. The duration and pH of alkalosis were significantly higher In the control group. Conclusions: Short duodenal regurgitation after a meal may be a physiological phenomenon. Allergic gastroesophageal reflux on the basis of duodenogastric reflux is one of the main types of gastroesophageal reflux in children. Fasting and lying position Gastroesophageal pH monitoring is of greater value in the diagnosis of pathologic reflux.