文章摘要

24 h食管pH监测在儿童疑诊胃食管反流病不同临床表现中的应用

作者: 1李 杨, 1谢 晓丽, 1熊 励晶, 1杜 丽娜
1 成都市妇女儿童中心医院儿童消化科,成都 610031
通讯: 谢 晓丽 Email: 1592397014@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.02.018

摘要

目的:探讨24 h食管pH监测在儿童疑诊为胃食管反流病(gastroesophageal reflux disease,GERD)不同临床表现中的应用。方法:纳入将2017年3月至2018年6月在成都市妇女儿童中心医院门诊通过临床表现疑诊为胃食管反流(gastroesophageal reflux,GER)的119例患儿,并对其进行24 h食管pH监测。根据其主要临床表现分为3组:A组为典型反流症状,B组为非典型反流症状,C组为消化道外症状,其中A组60例,B组29例,C组30例。比较3组病理性GER患儿的总pH值<4的总时间百分比、立位pH值<4的时间百分比、卧位pH值<4的时间百分比、pH值<4的反流次数、酸反流>5 min的次数、最长反流持续时间、Boi x-Ochoa得分、酸反流指数等指标。结果:A组40例(66.67%)为病理性GER;B组20例(68.97%)为病理性GER;C组20例(66.67%)为病理性GER。3组患儿病理性GER阳性率差异无统计学意义(P>0.05),3组病理性GER患儿的pH值<4的总时间百分比、立位pH值<4的时间百分比、卧位pH值<4的时间百分比、pH值<4的反流次数、酸反流>5 min的次数、最长反流持续时间、Boi x-Ochoa得分、酸反流指数的差异均无统计学意义(均P>0.05)。结论:24 h食管pH监测在GERD的诊断及疗效评价中起不可替代的重要作用,推荐用于非典型反流症状或消化道外症状起病的GERD、非糜烂性反流病(non-erosive reflux disease,NERD)或抗反流药物疗效欠佳的患儿。
关键词: 24 h食管pH监测;胃食管反流病;疑诊;儿童

Application of 24 h esophageal pH monitoring in different clinical manifestations of children with suspected gastroesophageal reflux disease

Authors: 1LI Yang, 1XIE Xiaoli, 1XIONG Lijing, 1DU Lina
1 Department of Gastroenterology, Chengdu Women and Children’s Center Hospital, Chengdu 610031, China

CorrespondingAuthor:XIE Xiaoli Email: 1592397014@qq.com

Abstract

Objective: To investigate the application of 24-hour esophageal pH monitoring in children with suspected gastroesophageal reflux disease (GERD). Methods: From March 2017 to June 2018, 119 children with suspected gastroesophageal reflux (GER) who were suspected of having gastroesophageal reflux (GER) were enrolled in the outpatient clinic of Chengdu Women and Children’s Center Hospital for 24 h esophageal pH. monitor. According to their main clinical manifestations, they were divided into three groups: group A was typical reflux symptoms; group B was atypical reflux symptoms; group C was extra-gastrointestinal symptoms, including 60 cases in group A, 29 cases in group B, and 30 cases in group C. The total pH value of the three groups of pathological GER patients <4 time of percentage, standing pH value <4 time percentage, lying pH value <4 time percentage, pH <4 reflux number, the times of acid reflux >5 min were compared. The number of times, the longest reflux duration, the Boix-Ochoa score, the acid reflux index and other indicators. Results: A total of 60 patients in group A, 40 (66.67%) were pathological GER; 29 patients in group B, of which 20 (68.97%) were pathological GER; 30 patients in group C, 20 (66.67%) of which were pathological GER. There was no significant difference in the positive rate of pathological GER between the three groups (P>0.05). The total pH value of the three groups of patients with pathological GER was <4 time of percentage, the standing pH value was <4 time percentage, and the lying position pH value <4 time percentage, pH <4 reflux number, the times of acid reflux >5 min, longest reflux duration, Boix-Ochoa score, acid reflux index were not statistically significant (P>0.05). Conclusion: 24 h esophageal pH monitoring plays an irreplaceable role in the diagnosis and efficacy evaluation of GERD. It is recommended for GERD, non-erosive reflux disease (NERD) for atypical reflux symptoms or extra-gastrointestinal symptoms, or children with poor anti-reflux medications.
Keywords: 24 h esophageal pH monitoring; gastroesophageal reflux disease; suspected; children