46例儿童吞气症单中心回顾性分析

A single-center retrospective analysis of 46 children with aerophagia

摘要:

目的 探讨儿童吞气症的临床特点。方法 对2011年10月至2019年9月南京医科大学附属儿童医院中心诊治的46例吞气症患儿的临床资料进行回顾性分析。结果 46例吞气症患儿中，15例（33%）合并多发性抽动症（TS）。腹胀为最主要的症状（45例，98%）。24 h食管阻抗检测显示，24 h气体吞咽次数平均为341次，24 h气体反流次数平均为212次，直立位气体反流占总气体反流比例为95%。合并TS患儿与未合并TS患儿相比，吞气症状发生率明显高于单纯吞气症患儿（67% vs 6%，P < 0.001），其他症状及24 h食管阻抗结果二者无明显差异。通过饮食调整、心理行为治疗及药物干预，患儿临床症状评分、儿童生活质量评分均得到明显改善，其中心理行为治疗为重要干预措施之一。结论 部分吞气症患儿合并TS，合并TS的患儿吞气症状更常见；心理行为治疗为吞气症患儿重要的治疗方法之一，患儿预后良好。

Abstract:

Objective To study the clinical features of aerophagia in children. Methods A retrospective analysis was performed on the medical data of 46 children with aerophagia who were diagnosed and treated in Children's Hospital Affiliated to Nanjing Medical University from October 2011 to September 2019. Results Among these 46 children, 15 (33%) had Tourette syndrome. Abdominal distension was the most common symptom and was observed in 45 children (98%). The 24-hour esophageal multichannel intraluminal impedance monitoring showed a mean number of 341 times of air swallowing and a mean number of 212 times of gas reflux, and 95% of gas refluxes occurred in the upright body position. Compared with those without Tourette syndrome, the children with Tourette syndrome had a significantly higher incidence rate of air swallowing symptoms (67% vs 6%, P < 0.001), but there were no significant differences in other symptoms and the results of 24-hour esophageal impedance. Dietary adjustment, psycho-behavioral therapy, and drug intervention significantly improved the scores of clinical symptoms and quality of life, among which psycho-behavioral therapy was an important intervention measure. Conclusions Some children with aerophagia may have Tourette syndrome, and such children are more likely to have air swallowing symptoms. Psycho-behavioral therapy is one of the most important treatment methods, and children with aerophagia tend to have a good prognosis after treatment.