López Alonso M, Moya M J, Cabo J A, Ribas J, Macías M C, Silny J, Sifrim D
Dpto. Cirugía Pediátrica. Fundación Reina Mercedes. HUI Virgen del Rocío, Sevilla.
Cir Pediatr. 2005 Jul;18(3):121-6.
Preterm infants present often Gastroesophageal refluxes (GER). Esophageal pH monitoring to reflux detection is of limited use in this infants because their gastric pH is normally higher than 4 for 90% of the time. Other methods such as the Intraluminal Impedance Technique (MII) technique and the use of micromanometric catheters try to palliate the difficulties for measuring GER by pH monitoring. The aim of this study, in a first step, was to obtain the normal Intraluminal Impedance values on control children and, in a second step, to study the relationship between GER and cardiorespiratory episodes using simultaneous recording of the end-tidal fraction of expired CO2, 02 saturation by pulse-oximetry, respiratory frequency, esophageal impedance and manometry, gastro-esophageal pHmetry, and electrocardiography in selected patients. Data from simultaneous pH and Intraluminal Impedance during 24 hours in 7 control preterms showed 89 acid refluxes, 192 non-acid refluxes, 79.36% of all refluxes reached the proximal esophagus. Therefore the impedance is an innocuous method which opens new horizons in the study of such a common illness as the GER in the preterm infants.
早产儿常出现胃食管反流(GER)。食管pH监测用于反流检测对这些婴儿的作用有限,因为他们的胃pH值通常90%的时间高于4。其他方法,如腔内阻抗技术(MII)和使用微测压导管,试图缓解通过pH监测测量GER的困难。本研究的目的,第一步是获得对照儿童的正常腔内阻抗值,第二步是在选定患者中通过同时记录呼出二氧化碳的潮气末分数、脉搏血氧饱和度、呼吸频率、食管阻抗和测压、胃食管pH测量以及心电图,研究GER与心肺事件之间的关系。7名对照早产儿24小时内同时进行pH和腔内阻抗的数据显示有89次酸反流、192次非酸反流,所有反流的79.36%到达食管近端。因此,阻抗是一种无害的方法,为研究早产儿中如此常见的疾病GER开辟了新的视野。