危重症患者胃食管反流的临床诊断研究  

Clinical Diagnosis of Gastroesophageal Reflux in Critically ILL Patients

作　　者：陈维顺[1] 李舜午[1] 彭苏娜 罗虹雨[1] 周婷[1] 张敏洁[1] 

机构地区：[1]中南大学湘雅医学院株洲临床学院,湖南省株洲市一医院消化内科,株洲412000

出　　处：《临床消化病杂志》2013年第5期307-309,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的分析危重症患者动态食管内pH及胆汁反流监测结果及用于临床诊断的可行性。方法观察组41例为我院危重症监护病房(1CU)的患者。对照组41例为同期具有反酸、烧心、胸痛后不适,咳嗽等反流症状,临床诊断为胃食管反流的普通患者,两组行24 h动态食管内pH及胆汁反流监测。结果观察组单纯酸反流者4例(9.8%),单纯胆汁反流者13例(31.7%),混合反流者15例(36.5%),无酸和胆汁反流者9例(21.9%),胆汁反流者明显多于酸反流病人(χ2=4.03,P<0.05)。与对照组比较,观察组酸反流少,胆汁反流多,尽管反流次数少,但每次反流时间长,特别是最长反流时间明显增加,与对照组比较均有显著性差异(P均<0.05)。结论动态食管内pH及胆汁监测适合于危重症患者的诊断,在结果分析时应充分考虑其反流特点。Objective To analyze the results of 24 h esophageal pH and bile monitoring in critically II patients and investigate the feasibility of the two Methods for clinical diagnosis. Methods 41 one critically II patients in Intensive Care unit were used as study group and 41 one patients with symptoms of reflux such as acid reflux ,heartburn ,chest pain ,coughing which clinical diagnosis of gastroesophageal reflux（GER） as control group. All cases underwent 24 h pH and bile monitoring with sensor catheters. Results In study group, we observed that acid reflux 4 cases （9.8%）, bile reflux 13 cases （31.7% ）, mixed reflux 15 cases （36.5%） and no reflux 9 patients （21.9%）. From these we considered that bile reflux easesare significantly more than acid reflux in this group （ X2 = -4.03, P 〈 0.05 ）. Although the frequence of the reflux is less compared with the controlgroup, the time is longer, especially the longest reflux time is significantly increased. All of the results are distinctly different eomparedwith the control group （ P 〈 0.05 ）. Conclusion 24 h esophageal pH and bile monitoring are fit to diagnose GER in critically II patients, but the characteristic of reflex should be fully considered when analyzing the results.

关 键 词：危重症 胃食管反流 诊断 24h食管内pH监测 24h食管内胆汁监测 

分 类 号：R571[医药卫生—消化系统] R573[医药卫生—内科学]