24h食管pH监测在婴儿喘息性疾病中的应用  

Application of 24-Hour Esophageal pH Monitoring in Infantile Wheezing

作　　者：付四毛[1] 黄娟[1] 郭小玲[1] 熊勇[1] 龙晓玲[1] 刘玉玲[1] 

机构地区：[1]南方医科大学附属中山博爱医院儿科,广东中山528400

出　　处：《实用儿科临床杂志》2010年第4期274-275,301,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨24 h食管pH监测在婴儿喘息性疾病中的应用。方法对74例喘息性疾病婴儿进行24 h食管pH监测,监测指标包括食管pH<4.00的次数、反流时间≥5 min的次数、最长反流时间、卧位pH<4.00的时间占总监测时间的百分比以及Biox-Ochoa评分;对所有喘息患儿按照病情分为持续性喘息组和一般喘息组,比较2组24 h食管pH监测情况;将其中有病理性胃食管反流(GER)的40例患儿随机分为治疗组和对照组。对照组给予常规抗炎、平喘治疗,治疗组在抗炎、平喘治疗基础上加用抗GER治疗。比较2组患儿住院时间和肺部啰音消失时间?峁?4例喘息性疾病患儿病理性GER发生率为54.0%。其中持续性喘息组病理性GER发生率(69.4%),显著高于一般喘息组(39.5%);持续性喘息组各项反流指标均高于一般喘息组(Pa<0.01)。治疗组患儿住院时间、肺部啰音消失时间均较对照组明显缩短,差异均有统计学意义(Pa<0.01)。所有患儿在24 h食管pH监测中未出现严重不良反应,无终止监测的发生。结论喘息性疾病患儿病理性GER发生率高,持续性喘息患儿发生率更高。伴有病理性GER的喘息患儿经抗GER治疗后效果明显。24 h食管pH监测安全,对婴儿喘息性疾病的诊断及指导治疗有重要价值。Objective To explore the application of 24 - hour esophageal pH monitoring in infantile wheezing. Methods Twenty - four - hour esophageal pH monitoring was performed in 74 infants with wheezing and the frequencies of pH 〈 4.00, the frequencies of refluxes lasting longer than 5 min,and the longest episode of reflux,the percentage of time of pH 〈4.00 at supine position,and Boix - Ochoa grade were recorded. All the infants were divided into persistent wheezing group and normal wheezing group, 24 - hour esophageal pH monitoring of the 2 groups were compared. Forty children with gastroesophageal reflux（GER） were divided randomly into control group and treatment group. The patients in control group were managed with regular anti - inflammatory and antiasthmatic therapy, and the patients in treatment group were treated with anti - reflux drug plus basic treatment. The hospital stay and the disappearance time of pulmonary rale were compared between the 2 groups. Results Fifty - four percent of the wheezing infants were diagnosed as pathological GER,69.4% of the recurrent wheezing infants were diagnosed as GER. All parameters in infants with recurrent wheezing were significantly higher than those in common wheezing patients （Pa 〈 0. 01 ）. The treatment time was significantly shortened in GER infants treated with anti - GER treatment than those in control group （Pa 〈 0.01 ）. All the children in the 24 - hour esophageal pH monitoring did not appear serious adverse reactions, no termination of monitoring took place. Conclusions There is a high incidence of GER in wheezing infants, especially in recurrent wheezing patients. Anti - GER treatment is effective in wheezing infants with GER, and 24 - hour esophageal pH monitoring is so safe, and that can be helpful for making diagnosis and treating of gastroesophageal reflux in infantile recurrent wheezing.

关 键 词：24 h食管pH监测 胃食管反流 喘息 婴儿 

分 类 号：R725.6[医药卫生—儿科]