Koumanidou C, Vakaki M, Pitsoulakis G, Anagnostara A, Mirilas P
Department of Radiology, Agia Sofia Children's Hospital, Thivon and Mikras Asias Sts., Goudi, Athens 11527, Greece.
AJR Am J Roentgenol. 2004 Sep;183(3):801-7. doi: 10.2214/ajr.183.3.1830801.
Our aim was to provide exact sonographic measurements of the abdominal esophagus length in neonates and infants with and without gastroesophageal reflux (GER) and to investigate its diagnostic value. GER severity and hiatal hernia presence were also evaluated and correlated with esophageal length.
This retrospective case-control study comprised 258 neonates and infants (150 without reflux and 108 with reflux). There were 50 children without reflux in each of three age categories: less than 1 month, 1-6 months, and 6-12 months. Of the children with reflux, 42 were less than 1 month old; 34, 1-6 months; and 32, 6-12 months. The abdominal esophagus was measured from its entrance into the diaphragm to the base of gastric folds in fed infants. The number of refluxes during a 10-min period were recorded; GER was categorized as mild, one to three refluxes; moderate, three to six refluxes; and severe, more than six refluxes. Presence of hiatal hernia was recorded.
Neonates and infants with reflux had a significantly shorter abdominal esophagus than subjects without reflux: the mean difference in neonates, 4.8 mm; 1-6 months, 4.5 mm; 6-12 months, 3.4 mm. Children with severe reflux had a shorter esophagus compared with those with mild and moderate reflux only in the neonate group. In contrast, children with reflux associated with hiatal hernia had a significantly shorter esophagus compared with children with mild reflux in all three age groups. Sonographic sensitivity was 94%.
Sonographic measurement of the abdominal esophagus length is highly diagnostic for GER in neonates and infants. In neonates, it can also indicate GER severity. Hiatal hernia is associated with a significantly shorter abdominal esophagus.
我们的目的是对有和没有胃食管反流（GER）的新生儿和婴儿的腹部食管长度进行精确的超声测量，并研究其诊断价值。还评估了GER的严重程度和食管裂孔疝的存在情况，并将其与食管长度进行关联。
这项回顾性病例对照研究包括258例新生儿和婴儿（150例无反流，108例有反流）。三个年龄组中每组无反流的儿童各有50例：小于1个月、1至6个月和6至12个月。在喂食的婴儿中，从腹部食管进入膈肌处测量至胃皱襞基部。记录10分钟内的反流次数；GER分为轻度，1至3次反流；中度，3至6次反流；重度，超过6次反流。记录食管裂孔疝的存在情况。
有反流的新生儿和婴儿的腹部食管明显短于无反流的受试者：新生儿的平均差异为4.8毫米；1至6个月为4.5毫米；6至12个月为3.4毫米。仅在新生儿组中，重度反流的儿童与轻度和中度反流的儿童相比食管较短。相比之下，在所有三个年龄组中，伴有食管裂孔疝的反流儿童与轻度反流儿童相比食管明显较短。超声检查的敏感性为94%。
超声测量腹部食管长度对新生儿和婴儿的GER具有高度诊断价值。在新生儿中，它还可以指示GER的严重程度。食管裂孔疝与明显较短的腹部食管相关。
