Yang Grace S, Bishop Warren P, Smith Brian J, Goudy Steven L, Sato Yutaka, Bauman Nancy M
Department of Otolaryngology-Head and Neck Surgery University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA.
Ann Otol Rhinol Laryngol. 2005 Aug;114(8):587-92. doi: 10.1177/000348940511400802.
Knowledge of the length between the upper esophageal sphincter (UES) and the lower esophageal sphincter (LES) in pediatric patients is essential for intraluminal impedance and dual pH probe recordings.
We measured the vertical distance between the true vocal cords (TVCs) and the LES in chest x-rays (CXRs) of 118 children (ages, 6 weeks to 13 years) and measured the vertical distance between the UES and the LES during endoscopy in 31 patients (ages, 14 months to 17 years) and correlated the measurements to height, weight, and age.
Esophageal length correlated best with patient height (R = 0.96 by CXR, R = 0.88 by endoscopy) and less well with weight (R = 0.87, R = 0.67) and age (R = 0.94, R = 0.86). Linear regression analyses using radiographic measurements revealed that esophageal length (TVC to LES) can be estimated from a patient's height by the following equation: 1.048 + 0.167 x height (in centimeters). With the upper pH probe placed in the hypopharynx at the TVC level and the inferior probe placed in the esophagus 3 to 6 cm above the LES, the patients were divided into 6 groups corresponding to the currently available number of sizes of dual pH-impedance probes. With the patients' heights between 71.5 and 161.3 cm, 64.7% to 100% of patients were within 1 cm of the desired location with preselected probes. Confirmation of placement was performed with CXR.
A pediatric patient's height can be used to estimate the esophageal length (TVC to LES) and facilitate the selection of dual pH-impedance probes. Our method decreases the risk of morbidity while increasing the accuracy of the study of extraesophageal reflux disease.
了解小儿患者上食管括约肌（UES）与下食管括约肌（LES）之间的长度对于腔内阻抗和双pH探头记录至关重要。
我们在118名儿童（年龄6周至13岁）的胸部X线片（CXR）中测量了真声带（TVC）与LES之间的垂直距离，并在31名患者（年龄14个月至17岁）的内镜检查期间测量了UES与LES之间的垂直距离，并将测量结果与身高、体重和年龄进行关联。
食管长度与患者身高的相关性最佳（CXR测量的R = 0.96，内镜检查的R = 0.88），与体重（R = 0.87，R = 0.67）和年龄（R = 0.94，R = 0.86）的相关性稍弱。使用放射学测量进行的线性回归分析显示，食管长度（TVC至LES）可通过以下公式根据患者身高进行估计：1.048 + 0.167×身高（以厘米为单位）。将上部pH探头置于下咽的TVC水平，下部探头置于LES上方3至6厘米的食管中，根据目前可用的双pH阻抗探头尺寸数量将患者分为6组。患者身高在71.5至161.3厘米之间时，64.7%至100%的患者使用预选探头时位于所需位置的1厘米范围内。通过CXR确认探头位置。
小儿患者的身高可用于估计食管长度（TVC至LES），并有助于双pH阻抗探头的选择。我们的方法降低了发病风险，同时提高了食管外反流疾病研究的准确性。
