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目的探讨小儿胃食管反流病(GERD)的临床特点与诊断。方法对50例GERD的临床资料进行回顾性分析。结果小儿GERD以新生儿和婴幼儿发病较多,<3岁者占83%(41/50)。临床表现以溢奶或呕吐为主等反流症状外,80%具有呼吸系统疾病,16%无呕吐症状。43例行24h食管pH监测,其中41例异常,检出率95%。13例行食管钡剂造影阳性10例,诊断阳性率为76%。结论小儿胃食反流临床表现复杂且缺乏特异性,仅凭临床症状有时难以与其他引起呕吐的疾病相鉴别,即使是胃食管反流也难以区分是生理性或病理性。食管24hpH连续监测配合食管胃钡餐造影是早期诊断小儿GERD的重要方法。
Objective To investigate the clinical features and diagnosis of children with gastroesophageal reflux disease (GERD). Methods The clinical data of 50 cases of GERD were retrospectively analyzed. Results The incidence of GERD in infants and infants was higher than that in children <3 years old (83%, 41/50). Clinical manifestations of spilled milk or vomiting and other reflux symptoms, 80% of respiratory diseases, 16% no vomiting. 43 cases of 24h esophageal pH monitoring, of which 41 cases were abnormal, the detection rate was 95%. 13 cases of esophageal barium positive in 10 cases, the positive rate of 76%. Conclusion The clinical manifestations of pediatric gastroesophageal reflux disease are complicated and lack of specificity. Sometimes it is difficult to differentiate the disease from other vomiting based on the clinical symptoms. Even gastro-oesophageal reflux is difficult to distinguish between physiological and pathological. Continuous monitoring of esophageal 24hpH with esophagogastric barium meal is an important method for early diagnosis of children with GERD.