摘要
目的 探讨早产儿胃电节律特点与胃食管反流 (GER)的关系、西沙比利混悬液对GER的疗效。方法 1998年 5月～ 1999年 5月在我院产科分娩的早产儿 41例 ,其中男 2 3例、女 18例。用DigitraperMKⅢ型pH监测仪和Digitraper胃电图 (EGG)检测仪进行食管 2 4hpH监测及胃电图检测 ,根据腹部X线平片胃在体表投影确定胃体、胃窦的位置放置胃电图电极。喂奶前后各记录 30min。食管 2 4hpH监测结果 ,根据ESPGAN记分法 ,反流时间百分比超过该年龄组正常值 (13% )的患儿为GER阳性 ,给以西沙比利混悬液口服治疗 ,剂量为每次 0 .2ml/kg,每日 3次。用药 10日后复查食管2 4hpH监测和胃电图。结果 (1)GER的检出率为 2 1/ 41(5 1% )。治疗后复查食管 2 4hpH监测结果19例转为阴性 ,治愈率为 91%。 (2 )全组胃电图检查结果 :胃电节律过缓 :餐前 (43.5± 0 .2 ) % ,餐后(47.7± 3.9) %、正常胃电节律 :餐前 (33.2± 2 .9) % ,餐后 (2 8.4± 2 .4) %、胃电节律过速 :餐前 (2 2 .8±2 .9) % ,餐后 (2 2 .5± 2 .5 ) %。餐后餐前功率比 1.5± 0 .5。 (3)无反流组和有反流组的正常胃电节律(2 .4～ 3.7)cpm百分比分别为餐前 (34± 4) %和 (32± 4) % (P >0 .0 5 ) ;餐后 (2 9± 3) %和 (2 8± 3) % (P>0 .0 5 ) ;
Objective To investigate the electrogastrogram (EGG) and the relation between EGG findings and gastroesophageal reflux (EGR) of premature infants and to observe the response to cisapride for GER. Methods Forty one premature infants (23 male and 18 female; average age 33.4 weeks; mean body weight 1 780 g) born in the obstetric department of PUMC Hospital between May 1998 and May 1999 were enrolled in this study. EGG was recorded for 30 min during fasting and for 30 min postpradially with Digitraper EGG (CTD,Sweden), placing the surface electrodes in upper abdomen according to projection of gastric antrum according to abdominal plane X ray film. Esophageal 24 h pH monitoring was performed with Digitraper MK (CTD, Sweden) and the infants who were found to have infinite GER (with the percentage of reflux time more than 13% according to ESPGAN score) were treated with cisapride (0.2ml/kg, 3 times a day) for 10 days. EGG and 24 h pH test were repeated after the 10 day treatment. Results (1) GER was found in 21/41(51 %) cases. GER disappeared in 19/21 (91%) cases after treatment. (2) In the whole series of infants, during fasting and after feeding, bradygastria was found in (43.5±0.2)% and (47.7±3.9)%, normal rhythm in (33.2±2.9) % and (28.4±2.4)%, and tachygastria in (22.8±2.9)% and (22.5±2.5) %, respectively; the power ratio was 1.5±0.5. (3) The percentages of infants with and without GER who showed normal rhythm (2.4 3.7)cpm were (34±4)% and (32±4)% ( P >0.05) before feeding and (29±3)% and (28±3) % ( P >0.05) after feeding; the dominant frequencies were (2.4±0.4) cpm and (1.7±0.4) cpm ( P <0.01) before feeding and (1.6±0.4) cpm,(1.8±0.3) cpm ( P >0.05) postpradially; power ratio was 2.9±1.2 and 0.7±0.1 ( P <0.01). (4) After treatment with cisapride, the percentage of normal rhythm, bradygastria, tachygastria and power ratio at fasting and after feeding had no significant difference, so was the dominant frequency. Conclusions (1) The distribution of gastric electric rhythm in premature infant (the frequencies of 2.4 3.7 cpm were seen in only about 30%) was different from that in adults. (2) The correlation between gastroelectric rhythm and GER in premature infants remains to be clarified. (3) cisapride could control gastric reflux of premature infants effectively, but could not alter the gastric rhythm during short treatment. (4) EGG appeared to be safe and reliable and can be performed easily in premature infants.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2000年第4期207-209,共3页
Chinese Journal of Pediatrics
关键词
胃食管反流
西沙比利
早产儿
胃电节律
Infant, premature
Gastroesophageal reflux
Electrogastrography
Piperidines
