Analysis of reflux impedance monitoring characteristics of gastroesophageal reflux disease in children
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维普
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目的 基于24 h食管多通道腔内阻抗-pH(24 h MII-pH)监测技术,分析胃食管反流病(GERD)患儿的反流与反流阻抗特点,探讨可能引起食管外症状的病理损伤机制.方法 回顾性分析2019年9月至2023年3月于湖北省妇幼保健院就诊并诊断为GERD的252例患儿临床资料,利用24 h MII-pH监测GERD患者的各项指标,分析其反流特点,包括反流物不同性质(液体、气体、混合)、酸度(酸、弱酸、无酸)、体位(直立位、仰卧位)和最高阻抗位(距贲门15 cm高度)的阻抗监测数据.结果 252例患儿中以呼吸系统症状为首发的有223例(88.5％).155例患儿成功完成24 h MII-pH监测获取报告,根据Boix-Ochoa综合评分>11.99分和酸暴露时间百分比(AET)>4％将患儿分为酸反流阳性组(GERD组,n=83)和酸反流阴性组(非GERD组,n=72),酸反流阳性率为53.6％.无论有无气体反流,GERD组酸反流阻抗次数多于非GERD组(P<0.05);有气体反流时,GERD组弱酸、无酸反流阻抗次数少于非GERD组(P<0.05).不同液体、气体、混合及酸度反流时,直立位反流阻抗次数多于仰卧位(P<0.05).GERD组酸、直立位、仰卧位反流阻抗次数多于非GERD组(P<0.05).两组总反流阻抗次数比较,差异无统计学意义(P>0.05).结论 气体反流可能在以消化道外症状为主要表现的GERD儿童中起着极为重要的作用.
Objective To analyze the characteristics of reflux and reflux impedance in children patients with gastroesophageal reflux disease (GERD) based on 24 h esophageal multichannel intracavitary impedance-pH (24 h MII-pH) monitoring technology,and to investigate the pathological injury mechanism possibly cau-sing extraesophageal symptoms.Methods The clinical data of 255 children patients with GERD visited and treated in this hospital from September 2019 to March 2023 were analyzed retrospectively.24 h MII-pH was used to monitor the various indexes of children patients with GERD.The reflux characteristics were analyzed,including different natures of reflux objects (liquid,gas,mixture),acidity (acid,weak acid,acid-free),position (upright position,supine position) and impedance monitoring data at highest impedance position (15 cm height from the cardia).Results Among 255 children patients,223 cases (88.5％) had the respiratory symp-toms as the initial onset.A total of 155 children patients completed the 24 h MII-pH monitoring and obtained the report.According to the Boix-Ochoa comprehensive score>11.99 points and acid exposure time percent-age (AET)>4％,the children patients were divided into the acid reflux positive group (GERD group,n=83) and acid reflux negative group (non-GERD group,n=72),and the gastric acid reflux positive rate was 53.6％.Whether or not having gas reflux,the times of acid reflux impedance in the GERD group were more than those in the non-GERD group (P<0.05);when the gas reflux existed,the reflux impedance times of weak acid and non-acid in the GERD group were less than those in the non-GERD group (P<0.05).When the reflux of different liquids,gases,mixed and acid reflux,the reflux impedance times of the upright position were more than those of supine position (P<0.05).The reflux impedance times of acid,upright position and supine position in the GERD group were more than those in the non-GERD group (P<0.05).The total reflux impedance times had no statistical difference between the two groups (P>0.05).Conclusion Gas reflux may play an extremely important role in GERD children with extragastrointestinal symptoms as the main manifes-tations.
childrengastroesophageal reflux disease24 h esophageal multichannel intracavitary impedance-pHgas refluxupright position reflux
维普
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