动态食管内pH及胆汁反流检测用于危重症患者胃食管反流的可行性分析  

Feasibility analysis of the dynamic esophageal pH and bile reflux detection for critically ill patients with gastroesophageal reflux

作　　者：林茂华[1] 黎小惠[1] 叶彬[1] 王智辉[1] 

机构地区：[1]博罗县人民医院内科,广东博罗516100

出　　处：《中国中西医结合消化杂志》2015年第3期156-159,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]研究动态食管内pH及胆汁反流检测用于危重症患者胃食管反流的可行性。[方法]收集我院ICU病房2012年1月~2014年1月的危重症患者120例,期间发生胃食管反流患者80例,作为观察组,另选取同期我院内科住院具有反流症状并且进行pH及胆汁反流检测患者50例,作为对照组,利用动态便捷pH检测仪和胆汁检测仪,检测2组反流情况。[结果]观察组单纯酸反流和单纯性胆汁反流发生率分别为10.0%、38.8%,而对照组分别为34.0%,10.0%,2组之间差别具有统计学意义（P〈0.05）;观察组混合性反流发生率为43.8%低于对照组的56.0%,但是2组之间差异无统计学意义（P〉0.05）。观察组病例性反流的63例（78.8%）,非病理性反流17例（21.2%）。2组经过24h动态食管pH检测,观察组病理性反流比例为78.8%低于对照组的94.0%,差异具有统计学意义（P〈0.05）,观察组酸反流次数少于对照组,差异具有统计学意义（P〈0.05）,观察组反流时间短于对照组以及最长反流时间长于对照组,但是2组之间差异无统计学意义（P〉0.05）。观察组胆汁反流次数少于对照组,但是2组之间差异无统计学意义（P〉0.05）,反流时间和最长反流时间均长于对照组的,2组之间差异具有统计学意义（P〈0.05）。[结论]动态食管内pH及胆汁监测不仅应用于普通胃食管反流,而且可应用于危重患者胃食管反流。危重症患者胃反流发生率较高,并且反流时间长,反流量大。[Objective]To study the feasibility of dynamic detection of esophageal pH and bile reflux for critically ill patients with gastroesophageal reflux disease（GERD）.[Methods]A total of 120 critically ill patients from ICU ward from January 2012 to January 2014 were selected,among whom 80 cases had gastroesophageal reflux and were taken as the observation group.Another 50 patients from internal medicine ward who showed reflux symptoms and conducted pH and bile reflux detection were selected during the corresponding period as a control group.A dynamic and convenient detection of pH tester and bile tester were used to detect the reflux conditions.[Results]The rate for simple acid reflux and simple bile reflux was respectively 10.0% and 38.8%,which was 34.0% and 10.0%in the control group,showing a statistically significant difference between the two groups（P〈0.05）.The rate of mixed reflux in observation group was 43.8%,which was lower than the occurrence of 56.0%in the control group,but there was no significant difference between the two groups（P〉0.05）.There were 63cases（78.8%）of pathological reflux and 17cases（21.2%）of non-pathological reflux in observation group.After 24 hambulatory esophageal pH detection in both groups,pathologic reflux ratio was 78.8%,which was lower than 94.0%in the control group,and the difference was statistically significant（P〈0.05）.The times for acid reflux in obser-vation group were fewer than that of the control group,and the difference was statistically significant（P〈0.05）.The reflux duration in observation group was shorter than that in the control group,and the longest reflux duration was longer than the control group,but no significant difference was found between the two groups（P〉0.05）.Bile reflux episodes in observation group were fewer than the control group,but no significant difference between the two groups（P〉0.05）.The mean and longest durations for bile reflux were longer than the control group,and the difference between the two group

关 键 词：动态食管pH 胆汁反流 胃食管反流 可行性分析 

分 类 号：R333.4[医药卫生—人体生理学]