Misra Sudipta, Macwan Kamlesh, Albert Viola
Division of Pediatric Gastroenterology, Department of Pediatrics, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois at OSF St. Francis Hospital, Peoria, Illinois, USA.
Acta Paediatr. 2007 Oct;96(10):1426-9. doi: 10.1111/j.1651-2227.2007.00442.x. Epub 2007 Sep 10.
The aetiological role of gastroesophageal reflux in apnea of prematurity is controversial. We hypothesized that transpyloric feeds, which decreases reflux and aspiration, will not be associated with decrease in reflux-related apnea.
The shows retrospective chart review of 41 premature babies on transpyloric feeds. Fifteen infants meeting the inclusion criteria of apnea of prematurity and clinical evidence of gastroesophageal reflux were included. Primary data points were number of apneas before and after transpyloric feeds. t-statistics was used for analysis.
Twelve of the 15 babies showed significant improvement on transpyloric feeds (p <. 005). The nonresponders were identified within 48 h. After discontinuation of transpyloric feeds, 2 responders underwent antireflux surgery and 9 were discharged without further intervention. No transpyloric-tube-related complication was documented.
Transpyloric feeds may be useful for diagnosis and management of suspected gastroesophageal-reflux-associated apnea in a selected group of infants.
胃食管反流在早产儿呼吸暂停中的病因学作用存在争议。我们推测经幽门喂养可减少反流和误吸，与反流相关的呼吸暂停减少无关。
对41例接受经幽门喂养的早产儿进行回顾性图表审查。纳入15例符合早产儿呼吸暂停纳入标准且有胃食管反流临床证据的婴儿。主要数据点是经幽门喂养前后的呼吸暂停次数。采用t检验进行分析。
15例婴儿中有12例经幽门喂养后有显著改善（p<.005）。无反应者在48小时内被识别。停止经幽门喂养后，2例有反应者接受了抗反流手术，9例未经进一步干预出院。未记录与经幽门管相关的并发症。
经幽门喂养可能有助于对选定婴儿组中疑似胃食管反流相关呼吸暂停的诊断和管理。
