联合食管多通道腔内阻抗-pH监测婴幼儿胃食管反流病

Application of combined esophageal multichannel intraluminal impedance-pH monitoring in infants and children with gastroesophageal reflux disease

摘要:

目的 评价24 h 联合食管多通道腔内阻抗-pH 监测（24 h MⅡ-pH）在婴幼儿胃食管反流病中的诊断价值，分析伴有反复肺炎的胃食管反流婴幼儿的反流特点。方法 疑诊胃食道反流的反复肺炎婴幼儿17 例，行24 h MⅡ-pH 监测，分析反流物性质和特点。结果 17 例患儿中阳性11 例（65%），共监测到853 次反流周期，其中65.3% 为酸反流，以餐后2 h 以内发生为主（69.5%）；71.6%为混合反流；反流发生的体位从多至少依次为直立位、仰卧位、侧卧位和俯卧位；反流物的高度以远端反流为主。根据Biox-ochoa 评分，重度反流的患儿占73%（8/11）。结论 联合食管MⅡ-pH 监测可分析反流物性质，增加胃食道反流病的检出率。

Abstract:

Objective This study aimed to evaluate the diagnostic value of a 24-hour esophageal combined multichannel intraluminal impedance pH (24 h our MⅡ-pH) monitoring in children with gastroesophageal reflux (GER) disease and recurrent pneumonia. Methods A total of 17 cases with a suspected diagnosis of GER disease children with unexplained recurrent pneumonia underwent a 24-hour MⅡ-pH monitoring to analysis of the nature and characteristics of reflux. Results In the 17 cases of GER disease with recurrent pneumonia, 11 (65%) were confirmed positively by a 24-hours of MⅡ-pH monitoring. A total of 853 reflux cycle were detected, of which 65.3% were acid refluxes predominantly occurring within 2 hours after meal, and 71.6% were mixed refluxes. Refluxes occurred most frequently in the supine position, followed by the lateral position and the prone position. Distal reflux was the predominant form of reflux. According to the Biox-Ochoa classification, 73% of cases (8/11) were severe GER. Conclusions MII-pH monitoring may effectively characterize refluxate properties and thereby increase the detection rate of GER disease.