|
|
小儿胃食管反流病诊断最新进展
|
Abstract:
胃食管反流病是由反流引起的具有临床表现的综合征，是儿科常见的上消化道动力障碍性疾病，该病的诊断主要依靠临床症状和相关检查综合判断，婴儿期临床表现多种多样，GERD严重时导致生长发育落后，甚至死亡，临床诊断困难，且国内尚缺乏诊断该疾病金标准，各医院之间诊断病例差异极大，本文介绍了食管pH检测，食管阻抗-pH监测，内窥镜检查和活检，唾液胃蛋白酶测量，钡餐检查，超声检查和质子泵抑制试验这些检查在诊断该疾病的最新研究进展。
Gastroesophageal reflux disease (GERD) is a syndrome with clinical manifestations caused by reflux, and it is a common upper gastrointestinal tract dysfunctional disease in pediatrics. The diagnosis of this disease mainly relies on the comprehensive judgment of clinical symptoms and related examinations, and the clinical manifestations are various in infancy, and GERD leads to growth retardation and even death in severe cases, which is difficult to diagnose clinically, and the gold standard for diagnosing this disease is still lacking in China, and the diagnosis varies among hospitals. This paper introduces the latest research progress of esophageal pH test, esophageal impedance-PH monitoring, endoscopy and biopsy, salivary pepsin measurement, barium meal examination, ultrasonography and proton pump inhibition test in the diagnosis of this disease.
| [1] | Sherman, P.M., Hassall, E., Fagundes-Neto, U., Gold, B.D., Kato, S., Koletzko, S., et al. (2009) A Global, Evidence-Based Consensus on the Definition of Gastroesophageal Reflux Disease in the Pediatric Population. The American Journal of Gastroenterology, 104, 1278-1295. https://doi.org/10.1038/ajg.2009.129 |
| [2] | 张娟, 李在玲, 葛颖, 等. 24小时食管多通道腔内阻抗联合pH监测技术在早产儿中的应用[J]. 中华儿科杂志, 2014, 52(4): 298-302. |
| [3] | Curien-Chotard, M. and Jantchou, P. (2020) Natural History of Gastroesophageal Reflux in Infancy: New Data from a Prospective Cohort. BMC Pediatrics, 20, Article No. 152. https://doi.org/10.1186/s12887-020-02047-3 |
| [4] | Bardhan, K.D. (1996) Duodenal Ulcer and Gastroesophageal Reflux Disease Today: Long-Term Therapy—A Sideways Glance. Yale Journal of Biology and Medicine, 69, 211-224. |
| [5] | Mousa, H. and Hassan, M. (2017) Gastroesophageal Reflux Disease. Pediatric Clinics of North America, 64, 487-505. https://doi.org/10.1016/j.pcl.2017.01.003 |
| [6] | Alcantara, J. and Anderson, R. (2008) Chiropractic Care of a Pediatric Patient with Symptoms Associated with Gastroesophageal Reflux Disease, Fuss-Cry-Irritability with Sleep Disorder Syndrome and Irritable Infant Syndrome of Musculoskeletal Origin. Journal of the Canadian Chiropractic Association, 52, 248-255. |
| [7] | El–Serag, H.B., Richardson, P., Pilgrim, P. and Gilger, M.A. (2007) Determinants of Gastroesophageal Reflux Disease in Adults with a History of Childhood Gastroesophageal Reflux Disease. Clinical Gastroenterology and Hepatology, 5, 696-701. https://doi.org/10.1016/j.cgh.2007.02.033 |
| [8] | Slater, B.J. and Rothenberg, S.S. (2017) Fundoplication. Clinics in Perinatology, 44, 795-803. https://doi.org/10.1016/j.clp.2017.08.009 |
| [9] | Dhillon, A. and Ewer, A. (2004) Diagnosis and Management of Gastro‐Oesophageal Reflux in Preterm Infants in Neonatal Intensive Care Units. Acta Paediatrica, 93, 88-93. https://doi.org/10.1111/j.1651-2227.2004.tb00680.x |
| [10] | Hibbs, A.M. and Lorch, S.A. (2006) Metoclopramide for the Treatment of Gastroesophageal Reflux Disease in Infants: A Systematic Review. Pediatrics, 118, 746-752. https://doi.org/10.1542/peds.2005-2664 |
| [11] | Rosen, R., Vandenplas, Y., Singendonk, M., Cabana, M., DiLorenzo, C., Gottrand, F., et al. (2018) Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Journal of Pediatric Gastroenterology and Nutrition, 66, 516-554. https://doi.org/10.1097/mpg.0000000000001889 |
| [12] | Clarrett, D.M. and Hachem, C. (2018) Gastroesophageal Reflux Disease (GERD). Missouri Medicine, 115, 214-218. |
| [13] | Ali, D.A., Brown, R.S., Rodriguez, L.O., Moody, E.L. and Nasr, M.F. (2002) Dental Erosion Caused by Silent Gastroesophageal Reflux Disease. The Journal of the American Dental Association, 133, 734-737. https://doi.org/10.14219/jada.archive.2002.0269 |
| [14] | Malaty, H.M., Abudayyeh, S., Fraley, K., Graham, D.Y., Gilger, M.A. and Hollier, D.R. (2007) Recurrent Abdominal Pain in School Children: Effect of Obesity and Diet. Acta Paediatrica, 96, 572-576. https://doi.org/10.1111/j.1651-2227.2007.00230.x |
| [15] | Vandenplas, Y., Salvatore, S., Devreker, T. and Hauser, B. (2007) Gastro‐Oesophageal Reflux Disease: Oesophageal Impedance versus pH Monitoring. Acta Paediatrica, 96, 956-962. https://doi.org/10.1111/j.1651-2227.2007.00306.x |
| [16] | Rosen, R., Furuta, G., Fritz, J., Donovan, K. and Nurko, S. (2008) Role of Acid and Nonacid Reflux in Children with Eosinophilic Esophagitis Compared with Patients with Gastroesophageal Reflux and Control Patients. Journal of Pediatric Gastroenterology and Nutrition, 46, 520-523. https://doi.org/10.1097/mpg.0b013e318158600c |
| [17] | Mousa, H., Machado, R., Orsi, M., Chao, C.S., Alhajj, T., Alhajj, M., et al. (2014) Combined Multichannel Intraluminal Impedance-pH (MII-pH): Multicenter Report of Normal Values from 117 Children. Current Gastroenterology Reports, 16, Article No. 400. https://doi.org/10.1007/s11894-014-0400-6 |
| [18] | Heard, R., Castell, J., Castell, D.O. and Pohl, D. (2012) Characterization of Patients with Low Baseline Impedance on Multichannel Intraluminal Impedance-pH Reflux Testing. Journal of Clinical Gastroenterology, 46, e55-e57. https://doi.org/10.1097/mcg.0b013e318247c319 |
| [19] | Smits, M.J., Loots, C.M., van Wijk, M.P., Bredenoord, A.J., Benninga, M.A. and Smout, A.J.P.M. (2015) An Expert Panel‐Based Study on Recognition of Gastro‐Esophageal Reflux in Difficult Esophageal pH‐impedance Tracings. Neurogastroenterology & Motility, 27, 637-645. https://doi.org/10.1111/nmo.12536 |
| [20] | Wenzl, T.G., Benninga, M.A., Loots, C.M., Salvatore, S. and Vandenplas, Y. (2012) Indications, Methodology, and Interpretation of Combined Esophageal Impedance‐pH Monitoring in Children. Journal of Pediatric Gastroenterology and Nutrition, 55, 230-234. https://doi.org/10.1097/mpg.0b013e3182592b65 |
| [21] | Loots, C.M., van Wijk, M.P., Blondeau, K., Dalby, K., Peeters, L., Rosen, R., et al. (2012) Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis. The Journal of Pediatrics, 160, 441-446.e1. https://doi.org/10.1016/j.jpeds.2011.08.017 |
| [22] | Pilic, D., Höfs, C., Weitmann, S., Nöh, F., Fröhlich, T., Skopnik, H., et al. (2011) Inter‐ and Intraobserver Agreement in 24‐Hour Combined Multiple Intraluminal Impedance and pH Measurement in Children. Journal of Pediatric Gastroenterology and Nutrition, 53, 255-259. https://doi.org/10.1097/mpg.0b013e318216940e |
| [23] | Ravi, K., DeVault, K.R., Murray, J.A., Bouras, E.P. and Francis, D.L. (2010) Inter-Observer Agreement for Multichannel Intraluminal Impedance-pH Testing. Diseases of the Esophagus, 23, 540-544. https://doi.org/10.1111/j.1442-2050.2010.01060.x |
| [24] | Rosen, R., Levine, P., Lewis, J., Mitchell, P. and Nurko, S. (2010) Reflux Events Detected by pH-MII Do Not Determine Fundoplication Outcome. Journal of Pediatric Gastroenterology and Nutrition, 50, 251-255. https://doi.org/10.1097/mpg.0b013e3181b643db |
| [25] | Duncan, D.R., Amirault, J., Johnston, N., Mitchell, P., Larson, K. and Rosen, R.L. (2016) Gastroesophageal Reflux Burden, Even in Children That Aspirate, Does Not Increase Pediatric Hospitalization. Journal of Pediatric Gastroenterology and Nutrition, 63, 210-217. https://doi.org/10.1097/mpg.0000000000001092 |
| [26] | Fortunato, J.E., D’Agostino, R.B. and Lively, M.O. (2016) Pepsin in Saliva as a Biomarker for Oropharyngeal Reflux Compared with 24‐hour Esophageal Impedance/pH Monitoring in Pediatric Patients. Neurogastroenterology & Motility, 29, e12936. https://doi.org/10.1111/nmo.12936 |
