Omari T
Gastroenterology Unit, Child Youth and Women's Health Service, North Adelaide, Australia.
Minerva Pediatr. 2008 Apr;60(2):193-200.
Gastroesophageal reflux (GER) is a very common condition that interrupts feeding and sleep routine in up to 30% of newborn infants. ''GER disease'' affects 3-5% of newborns and is defined when more serious complications are associated with GER. The diagnosis and treatment of GER disease in infants is fraught with difficulty due to the wide range of clinical presentations and the lack of diagnostic modalities and appropriate diagnostic criteria. These issues lead to failure to accurately diagnose reflux disease, or alternatively, over-diagnosis of reflux disease leading to the prescription of unnecessary and costly acid suppression therapies and surgical interventions. When faced with a newborn infant with GER, medical professionals prefer to offer parents a non-pharmacological therapy and/or some ''common sense'' advice rather than a drug. To date the only non-pharmacological intervention proven to reduce reflux is the positioning of infants on their left side after feeding. Despite this clear evidence, a left side positioning strategy has yet to be accepted by the wider medical community due to the current lack of appropriate evidence-based guidelines. This review will evaluate the basis left-side positioning as a simple, non-pharmacological approach to the treatment of GER related symptoms in preterm and term infants 0-6 months of age.
胃食管反流（GER）是一种非常常见的病症，在高达30%的新生儿中会干扰喂养和睡眠规律。“GER病”影响3%至5%的新生儿，当出现与GER相关的更严重并发症时可确诊。由于临床表现范围广泛、缺乏诊断方法和适当的诊断标准，婴儿GER病的诊断和治疗充满困难。这些问题导致无法准确诊断反流病，或者导致反流病的过度诊断，进而导致开具不必要且昂贵的抑酸疗法和手术干预处方。当面对患有GER的新生儿时，医疗专业人员更倾向于向家长提供非药物治疗和/或一些“常识性”建议，而不是药物。迄今为止，唯一被证明可减少反流的非药物干预措施是喂养后将婴儿置于左侧卧位。尽管有这一明确证据，但由于目前缺乏适当的循证指南，左侧卧位策略尚未被更广泛的医学界所接受。本综述将评估左侧卧位作为一种简单的非药物方法治疗0至6个月早产和足月婴儿GER相关症状的依据。
