婴幼儿食管裂孔滑疝与单纯胃食管反流的食管动力和pH分析  

Esophageal Motility and pH Monitoring of Infantile Gastroesophageal Reflux With or Without Siliding Hiatal Hernia LIN Ru,JIANG Mizu,HU J

作　　者：林茹[1] 江米足[1] 胡劲[1] 朱雄凯[1] 张泽伟[1] 

机构地区：[1]浙江医科大学儿童医院胸外科

出　　处：《中华胸心血管外科杂志》1999年第3期138-140,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：了解婴幼儿食管裂孔滑疝（ＳＨＨ组）和单纯胃食管反流（ＧＥＲ组）的食管动力和ｐＨ特点。方法：对１５例经钡餐造影（ＧＩ）和手术证实的ＳＨＨ和１３例单纯ＧＥＲ病儿进行了食管动力和２４小时食管ｐＨ监测。结果：反流参数ＳＨＨ组和ＧＥＲ组食管下段括约肌长度（ＬＥＳＬ）［（１３１±０３１）ｃｍ对（１９０±０４６）ｃｍ］、压力（ＬＥＳＰ）［（１２１５±５６３）ｍｍＨｇ对（２３８５±７５０）ｍｍＨｇ］、屏障压（ＢＰ）［（９３８±５６３）ｍｍＨｇ对（２２２０±７５０）ｍｍＨｇ］，ＳＨＨ组均明显低于ＧＥＲ组（Ｐ＜００１），而胃内压（ＧＰ）ＳＨＨ组高于ＧＥＲ组［（２１８±０６８）ｍｍＨｇ对（１５０±０３０）ｍｍＨｇ］，Ｐ＜００１。两组均有病理性反流，ＳＨＨ组反流参数除ｐＨ＜４反流次数外均高于ＧＥＲ组（Ｐ＜００１）。结论：ＳＨＨ的食管抗反流功能比单纯ＧＥＲ病儿明显低下，反流更严重。临床应对ＧＥＲ病儿特别是可疑ＳＨＨ者应定期进行食管动力和２４小时食管ｐＨ监测。Objective:To investigate the character of esophageal manometry and pH in infantile gastroesophageal reflux(GER) with or without sliding hiatal hernia(SHH)Clinical material and method :Ambulatory 24hr esophageal pHmetry and esophageal manometry were studied in 28 patients.All GER patients were divided into SHH group(n=15) and GER group(n=13).Results:Lower esophageal sphincter(LES) competence were significantly worsen in SHH group as compared with GER group,such as lower esophageal sphincter length ,P<0.01],lower esophageal sphincter pressure g,P<0.01],barrier pressure .The intragastric pressure in SHH group was significantly greater than that in GER group03.0)mm Hg, P<0.01].A second high pressure zone was found in 67% of patients (10/15) in SHH group,not in GER group.All cases showed the pathological gastroesophageal reflux.The reflux parameters,except total times of pH<4,were significantly greater in SHH group than in.GER group(P<0.01).Conclusion:GER patients with SHH had worse esophageal antireflux competency. GER patients,suspected of SHH should received routine esophageal manometric and pH examination.

关 键 词：食管裂孔疝 胃食管反流 食管测压 食管PH监测 

分 类 号：R655.4[医药卫生—外科学] R655.6[医药卫生—临床医学]