24h食管阻抗监测在儿童吞气症诊断中的作用  

The role of esophageal multichannel intraluminal impedance monitoring for 24 hours in diagnosis of aerophagia

作　　者：刘志峰[1] 郝理华[1] 金玉[1] 王珏[1] 孔桂萍[1] 

机构地区：[1]南京医科大学附属南京儿童医院消化科,210008

出　　处：《中华实用儿科临床杂志》2015年第7期498-500,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 探讨儿童吞气症的临床特点及24 h食管阻抗监测在儿童吞气症诊断中的作用.方法 选取2005年7月至2013年6月南京医科大学附属南京儿童医院消化科门诊接诊和住院部吞气症患儿30例,其中8例行24 h食管阻抗监测,分析其临床特点.患儿治疗主要包括心理疏导、饮食调节及口服乳果糖、多潘立酮口服液和多种维生素.经过上述处理仍然无效的患儿给于口服西甲硅油治疗.结果 30例患儿年龄2-13（8.6±4.5）岁,临床主诉为腹胀[30例（100.00％）],可以看见的或不自主的吞气现象28例（93.33％）,频繁嗳气27例（90.00％）,食欲不振25例（83.33％）,便秘22例（73.33％）,心理上有不同程度的压力15例（50.00％）,反复腹痛10例（33.33％）,慢性腹泻3例（10.00％）,急性腹痛3例（10.00％）.8例行24 h食管阻抗监测,24 h气体吞咽最多553次,最少1例47次,平均149.63次.经过心理疏导、饮食调节、口服药物治疗,其中24例（80.00％）得到缓解;6例（20.00％）严重者口服西甲硅油治疗后症状得到缓解.结论 儿童吞气症多表现为腹胀、不自主的吞气现象、频繁嗳气、食欲不振、便秘及反复腹痛.经心理疏导、饮食调节,适当的通便药、胃肠动力药和多种维生素治疗多可治愈.24 h食管阻抗监测检查可监测气体吞咽及气体反流,对儿童吞气症诊断有所帮助.Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children＇s Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged （8.6 ± 4.5） years,the chief complaints were abdominal distention in 30 cases （100.00%）,visible or audible air swallowing in 28 cases （93.33%）,repetitive belching in 27 cases （90.00%）,reduced appetite in 25 cases （83.33%）,constipation in 22 cases （73.33%）,psychological stresses in 15 cases （50.00%）,recurrent abdominal pain syndrome in 10 cases（33.33%）,chronic diarrhea in 3 cases（10.00%） and acute abdominal pain in 3 cases（10.00%）.Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 （47-553）times of air swallowing were recorded.In the 30 patients,24 cases （80.00%） were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases（20.00%） were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichann

关 键 词：吞气症 功能性胃肠病 多通道腔内阻抗技术 儿童 

分 类 号：R725.7[医药卫生—儿科]