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目的 了解小儿食管运动的生理学 ,探讨小儿病理性胃食管反流 (GER)发生的食管动力学基础。方法 对 6 0例健康儿童和 6 2例经食管pH监测诊断为病理性GER的患儿用低顺应性毛细管灌注系统进行食管测压研究 ,并对健康儿童组不同年龄段之间 ,两组同一年龄段之间进行食管动力功能比较。结果 健康儿童组下食管括约肌长度 (LESL)随着年龄的增加而增长 ,胸内段和腹内段也相应增加 (P <0 0 1) ,下食管括约肌压力(LESP)以～ 1岁组为高 (P <0 0 5 ) ;上食管括约肌长度 (UESL)随年龄的增加而增长 (P <0 0 1) ,上食管括约肌压力 (UESP)以～ 1岁组和～ 3岁组为低 (P <0 0 1)。病理性反流患儿的食管动力功能 ,除～ 7岁组食管蠕动传导速度低于同一年龄段健康儿童外 (P <0 0 5 ) ,其余指标两组同一年龄段间的差异均无显著性。结论 LESP的抗反流功能与年龄关系不大 ,LESL、UESL和UESP的功能 3岁以后逐渐成熟 ,小儿病理性GER的发生与LESP、LESL关系不大
Objective To understand the physiology of pediatric esophageal motility and to explore the basis of esophageal motility in pediatric pathological gastroesophageal reflux (GER). Methods A total of 60 healthy children and 62 children with pathological GER diagnosed by esophageal pH monitoring were studied with low compliance capillary perfusion system for esophageal manometry. Esophageal motility between age groups compared. Results The length of esophageal sphincter (LESL) in healthy children increased with age, and the intrathoracic and intra-abdominal segments also increased (P <0.01). The lower esophageal sphincter pressure (LESP) (P <0 05). The length of upper esophageal sphincter (UESL) increased with age (P <0.01), and the upper esophageal sphincter pressure (UESP) was lower in patients of ~ 1 year old and ~ 3 years old P <0 0 1). Esophageal motility in children with pathologic reflux was significantly lower than those in healthy children at 7 years old (P <0 05) except in the 7-year-old group, and no significant difference was found between the other two groups in the same age group . Conclusions The anti-reflux function of LESP is not related to age. The function of LESL, UESL and UESP gradually mature after the age of 3, and the incidence of pathological GER in pediatric patients is not related to LESP and LESL