小儿十二指肠胃返流与碱性胃食管返流的pH动态变化特点  

The Dynamic Changes of Gastroesophageal pH in Children with Duodenogastric Reflux and Alkaline Gastroesophageal Reflux

作　　者：王维林[1] 吉士俊[1] 王慧贞[1] 

机构地区：[1]中国医科大学第二临床学院小儿外科,沈阳110003

出　　处：《中华小儿外科杂志》1997年第3期139-141,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的:动态监测小儿十二指肠胃返流与碱性胃食管返流的 pH 变化特点,研究返流发生的病理生理意义。方法:对68例病理性胃食管返流小儿及39例正常小儿进行胃食管双 pH24小时动态监测,观察小儿在进餐及胃排空后以及不同体位下胃食管 pH 值的变化特点。结果:对照组中19例(48.7%)监测到十二指肠胃返流,以立位及进餐后发生为主,持续时间短暂。病理性胃食管返流者中22例(32.4%)监测到十二指肠胃返流及碱性胃食管返流,以空腹及卧位时发生为主,持续时间及 pH 值碱化强度显著高于对照组。结论:进餐后短暂的十二指肠胃返流可能为生理现象;在十二指肠胃返流基础上发生的碱性胃食管返流是小儿胃食管返流的主要类型之一;空腹及卧位时的胃食管双 pH 监测在诊断病理性返流中价值更大。Objective:To study the physiopathologic significance of duodenogastric reflux and alkaline gastroesophageal reflux in children.Methods:Twenty-four hour double gastroesophageal pH monitoring was performed on 68 patients with pathologic reflux and 39 normal children.The gastroesophageal pH was monitored in feeding state,gastric emptying and upright or supine pos- ture.Results:Duodenogastric reflux was observed on 19 cases(48.7%)of the control group.It was a transitory gastric pH alkalization after feeding and mainly in upright posture.Alkaline gas- troesophageal reflux and duodenogastric reflux were observed on 22 cases(32.4%)of pathologic reflux group and it was a marked gastroesophageal pH alkalization of longer duration,mainly in gastric emptying state and supine posture.Conclusions:Transitory duodenogastric reflux after feeding might be a physiologic phenomenon.Alkaline gastroesophageal reflux occurred on the ba- sis of duodenogastric reflux may be an important type of reflux in children with reflux diseases.To monitor the gastroesophageal pH in gastric emptying state and supine posture may be of great val- ue to detect the pathologic reflux.

关 键 词：胃酸测定 胃镜术 十二指肠 胃食管返流 儿童 

分 类 号：R725.704[医药卫生—儿科] R333.2[医药卫生—临床医学]