Connor Frances
Department of Gastroenterology, Hepatology and Nutrition, Royal Children's Hospital, Herston Road, Herston, Brisbane, QLD 4029, Australia.
Curr Gastroenterol Rep. 2005 Jun;7(3):219-26. doi: 10.1007/s11894-005-0038-5.
In children with medically refractory gastroesophageal reflux disease (GERD), fundoplication is effective and safe. However, in a subset of patients, gastrointestinal dysfunction occurs postoperatively. Symptoms include chest pain, persistent dysphagia in 5%, gas bloat in 2% to 4%, diarrhea in up to 20%, and dumping syndrome in up to 30%. Symptoms are often nonspecific, arising from recurrent or persistent GERD, anatomic complications such as disrupted or herniated wrap, functional disturbances such as rapid gastric emptying or altered gastric accommodation, or alternative diagnoses such as cyclic vomiting syndrome or food allergy. Detailed investigation, including various combinations of pHmetry, videofluoroscopy, endoscopy, motility studies, and dumping provocation testing, may be required to clarify pathophysiology and guide management.
在患有药物难治性胃食管反流病（GERD）的儿童中，胃底折叠术是有效且安全的。然而，在一部分患者中，术后会出现胃肠功能障碍。症状包括胸痛、5%的患者出现持续性吞咽困难、2%至4%的患者出现胃胀、高达20%的患者出现腹泻以及高达30%的患者出现倾倒综合征。症状通常不具有特异性，可能源于复发性或持续性GERD、解剖学并发症（如胃底折叠处破裂或疝出）、功能性紊乱（如胃排空过快或胃容纳改变）或其他诊断（如周期性呕吐综合征或食物过敏）。可能需要进行详细检查，包括pH值监测、视频透视、内镜检查、动力研究和倾倒激发试验的各种组合，以阐明病理生理机制并指导治疗。
